Wednesday, July 18, 2012

Flooding 101: Sandbags Over Swimming Lessons

[Had penned this in response to a commentary published this past weekend in the Globe and Mail. While I'm disappointed the Globe didn't want to publish it to provide balance to an article that I feel inexcusably misinformed their readers, the good news is that I have my own publishing platform.

Before reading my piece, you may want to have a peek at Patrick Luciani's Pop a Few Myths About Obesity]
Pop a Few Myths Perpetuated by Patrick Luciani

It looks like Patrick Luciani has solved the complexity of public policy for all of us by dumbing down the discussion of a novel and harmless approach to decreasing the consumption of soda (the Draconian measure of (gasp) limiting vendors' cup sizes to a half litre but not limiting the number that can be purchased) into a straw man argument that suggests that given a limit on New York City cup sizes won’t in and of itself solve the obesity crisis, that it’s clearly a pointless and ridiculous endeavour.

That was easy! Forget about the fact that when building a levee against a flood pointing out the fact that a single sandbag isn’t going to do the trick is a purposely asinine argument for a flood control policy analyst to make. 

But before we get carried away talking about levees and swimming lessons, let’s dispense with the myths that Mr. Luciani uses to defend the consumption of sugar water as being non-contributory to health woes.

Myth 1: The recent decline in soft drink consumption is laudable

Mr. Luciani presents a 30% decrease in per-capita Canadian soft drink consumption as evidence that there’s no need for intervention. Presenting this data in a vacuum is not only unwise, but also disingenuous. There are many sugared beverages out there and while soft drink consumption may have fallen to a still staggering 82 litres per Canadian per year, presenting the fall positively belies the fact that during the time soda consumption has decreased there has been a tremendous concomitant surge in the consumption of sugar spiked energy drinks and sports drinks. In fact one recent report on global energy drink sales states that the average growth rate has been 10 percent per year for each of the past five years.

Myth 2: Cherry picked data is useful

While it’s true that the article that Mr. Luciani himself reports, “has its limitiations”, suggested that soft drink consumption wasn’t linked to obesity in children, that doesn’t change the fact that there are studies that reveal the opposite to be true including the meta-analysis conducted by Harvard’s David Ludwig and published in Lancet which revealed that for each additional soda a child drinks on a daily basis their risk of developing obesity rises by 60%. Nutritional epidemiology is indeed a very tricky business, but no doubt cherry picking articles and presenting a rare outlier as being sufficient to discredit cursorily mentioned contradictory prior studies does not further intelligent debate.

Myth 3: Taxing food and beverages will be difficult so we shouldn’t try

Mr. Luciani suggests that because it will be difficult to determine what should and should not be taxed, that we therefore shouldn’t consider taxes as a means to shift consumption patterns. I have some news for Mr. Luciani, our current Excise Tax Act already does exactly that by making very specific suggestions for the collection of food taxes, many of which certainly don’t seem to make much nutritional sense. For instance the Excise Tax Act specifically singles out club soda, salads, vegetable and fruit trays and small bottles of water as taxable when sold in retail stores. Certainly shifting the taxes that are already currently being collected on healthful items onto glasses of sugar water would be a painless first step to take. Moreover, the simple fact that singular interventions won’t impact upon the complexity that is obesity shouldn’t paralyze the implementation of singular interventions as just as obesity has no one cause, it will have no one cure.

Myth 4: The fact that the food industry has healthier choices means they’re the good guys

The fact a particular industry makes healthier products doesn’t indemnify their risky ones. Altria for instance makes both shredded wheat and Marlboro cigarettes and I’d imagine even Mr. Luciani would struggle to suggest interventions designed to decrease smoking weren’t worthwhile on that ridiculous basis.

The food industry has a fiduciary responsibility to profit, not to protect our health. It’s important too, especially in this current climate to remember that profits aren’t built solely on sales. Profits are also built on public perception and the ability to make the case that industry unfriendly legislative efforts are unnecessary because the food industry is part of the solution. Mr. Luciani suggests McDonald’s, Pepsi and Coca Cola are all “going healthy to stay ahead of the market”. I’d argue they’re going healthy to stay ahead of legislation and scrutiny and to cultivate champions like Mr. Luciani who may be more inclined not to care that Coca-Cola’s stated aim is to double its profits in a decade because it makes zero-calorie beverages as well as its perennial profit-making full sugared version that according to Coca-Cola themselves along with other sugared sodas is responsible for an astonishing 2.5-3% of the total calories currently being consumed by Canadians. Putting 3% into perspective, since 1970 average Canadian loss adjusted per capita calorie consumption has risen by roughly 500 calories a day. If we’re currently averaging the 3,372 calories reported by the Canadian Sugar Institute, the 101 calories of soda being consumed daily would account for 20% of the total calorie excess we’ve seen since 1970 and consequently is an obvious, logical and nutritionally responsible target for intervention, especially given the complete and utter lack of nutritive value in its consumption.

Myth 5: Because Canada’s Food Guide isn’t evidence based we can’t trust the government to make smart decisions

It’s easy to agree that Canada’s Food Guide fails to reflect our current understanding of the impact of diet on chronic disease, but the fact that the government has failed to create a truly evidence based food guide has absolutely nothing to do with whether or not interventions to reduce the consumption of sugar water would be beneficial to the health of Canadians of all weights, shapes and sizes.

Mr. Luciani is right to state that obesity is incredibly complex and consequently there will be no, “top-down simple solution”, but suggesting education alone will suffice? Does Mr. Luciani truly believe Canadians don’t know that drinking 82L of sugared soda a year isn’t a healthy plan? Our current environment is flooded with calories with a torrential current that relentlessly, forcefully and tirelessly pushes Canadians young and old to consume far too many of them. When faced with a flood a government’s first job ought to be building a levee, not Mr. Luciani’s recommended course of action - more swimming lessons. And indeed, no single sandbag will suffice, and there will even be sandbags that serve no purpose, but that doesn’t mean we shouldn’t be systematically stacking them.

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6 comments:

  1. A very sad aspect of this is the Globe's responses.
    They first miss doing any scrutiny of the article.

    Then they refuse a well written response that would be a service to their readers and I presume free to them.

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  2. Very good posting.

    Saying that the government shouldn't do something (anything) to try to stop a serious public health problem is disingenuous and very wrong.

    Governments' purpose is to regulate. Who else is going to do it? The food/beverage industries can't be trusted to do it (one of the points you make). The eventual cost to publicly funded medical care mandates that something should be done.

    There are many legal items that have restricted use, rules around purchase, or higher taxes to moderate usage. Alcoholic products, tobacco, pesticides, fireworks, pesticides, drugs. Food products are not different.

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  3. You're mistaken about Altria/Phillip Morris and the Nabisco brands. It used to own Nabisco (makers of Shreddies and Shredded wheat -- which are popular Canadian cereals), but the food divisions of Altria (still P-M at the time) were all sold or spun off from Altria.

    This was done with shareholder and company support. I think many people thought that due to the risk of tobacco companies being sued out of existence, their food and tobacco businesses would be worth more to the market separated.

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  4. If it were in any way true that soda consumption is on the decline, I wonder why people like Mr Luciano are so opposed to the new restrictions,which after all, do not affect small and moderate portion sizes at all.

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  5. Anonymous11:07 am

    Well written post Yoni!

    I can't help but think of all the similarities between this issue and efforts to reduce smoking in Canada. As someone who works in the area of smoking cessation, it's clear that a lone intervention would clearly not 'solve' the issue, but it is the combination of many interventions (cigarette taxes, advertizing bans, public health campaigns, etc.) that have done so much to help reduce rates of smoking in Canada.

    Why should it be any different with food?

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  6. Anonymous12:59 pm

    If there is this much resitance to a completely reasonable limit on extreme serving sizes, we will need every voice to get more significant changes made!

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