Friday, 7 May 2021

Last Orders with Geoff Norcott

There's a new episode of Last Orders out with special guest Geoff Norcott. We talk about working class Tories, the state of Britain’s pubs and PC policing. It was recorded before the election results came through, btw.

You non-subscribers can listen here.

Jamie Oliver’s guilty sugar secret: his own recipes are full of the stuff

First published by Spectator Health in September 2015

Imagine a country in which state-subsidised television networks wheel out popular celebrities to scare the masses into supporting more taxes. Imagine no longer. This is not a dystopian future, this is Jamie’s Sugar Rush.

According to a Guardian journalist, Mr Oliver is ‘extremely well liked’. If so, I have drifted further from mainstream public opinion than I realised. In his guise as a TV evangelist on Channel 4 last night, he increasingly resembled a cadaver being zapped with electricity, all blank eyes and random facial expressions. ‘I’ve come here to get my head around it,’ he said with faux-naivety as he prepared to fire loaded questions at another sympathetic interviewee. In an hour of staged encounters and predictable factoids, it was the voyage-of-discovery charade that grated more than anything. It was always going to end with advertising bans, higher taxes and a new crusade for a celebrity chef. Channel 4 knew it, we knew it and Jamie knew it.

There were moments of propaganda in this programme that Kim Jong-Un would have rejected for being too crude. Towards the end, Oliver confronted a bunch of big-wigs to tell them about the revolutionary idea that had emerged from his awakening. The idea was a tax on sugar. Ooh, controversial. Jamie was nervous. How would they react?

Lo and behold, they liked it! Graham MacGregor spoke at length about his support for the proposal. Tam Fry thought it was great. Mike Rayner was also keen. What are the chances? It so happens that MacGregor is the chairman of Action on Sugar, Mike Rayner is a member of Action on Sugar (although the programme did not credit him as such) and Tam Fry, head of the National Obesity Forum, has been going on about taxing food for as long as I can remember. How fortuitous that three of the country’s leading anti-sugar fanatics were in the room.

The millionaire chef is now doing his bit by putting a ‘tax’ on sugary drinks in his own restaurants. The money will go towards a fighting fund to campaign for higher taxes for all. This is Oliver’s contribution to the fight against a product that he says is ‘evil’, a strong word and yet a strangely weak response. People who run vegan restaurants think that killing animals is evil, but they don’t settle for increasing the price of a steak by 10p. They stop serving it. Oliver’s approach is rather different. He hikes the price of a glass of Coke from £2.60 to £2.70 while selling cookery books which are, to put it gently, not wholly consistent with his trenchant anti-sugar views.

Jamie says we shouldn’t be eating more than seven teaspoons of sugar a day. Will he therefore be apologising for his ‘chocolate love cake’ recipe that contains 21 teaspoons of the stuff? What about his sticky toffee pudding (12 teaspoons) or his tasty sundae (16 teaspoons)? Will he be recalling and pulping the cookery book that gave the world his recipe for gluten-free Christmas cake in which every slice had 28 teaspoons? (Jamie has not yet updated his website to include the new sugar guidelines, but that is now four times the recommended daily amount.)

‘Those are desserts!’, I hear you cry. ‘It’s the ‘hidden’ sugars in breakfasts, main courses and drinks that are the real problem.’ OK then. In Jamie’s Sugar Rush, the great man bemoaned the ‘added sugars’ in bread. His own loaf requires two tablespoons — that’s tablespoons, not teaspoons. His pancakes, which were recently promoted in the Sunday Times as a ‘healthy breakfast’, have 17 grammes of sugar per serving — more than a bowl of Frosties. His salmon dish has three teaspoons of sugar, as does his chicken garden soup. As for drinks, how about trying one of Jamie’s milkshakes, which contain more sugar than a can of Coke?

I could go on and on. The point is not that Jamie Oliver has double standards. The point is that any professional chef would appear hypocritical if he started demonising a staple ingredient. Oliver’s recipes don’t use sugar excessively or gratuitously. They are not toxic, addictive or evil. They use as much sugar as is needed to give them the right taste and texture.

If you believe that a teaspoon of sugar is intrinsically harmful, any cookery book will terrify you, even Mrs Beeton’s. ‘Hiding’ ingredients is what chefs do. They are the sellers of ‘empty calories’, the ‘spikers’ of food, the ones who add the ‘added sugar’. Bread is supposed to have a bit of sugar in it. It doesn’t suddenly become a crime when Tesco does it. Everybody, please, calm down.

Jamie Oliver may truly believe that sugar is evil. He may genuinely think that it is dangerous to eat more than seven teaspoons of sugar a day. But if he took his beliefs to their logical conclusion as a restaurateur he would have to become a full-time television presenter to make a living because he would have no restaurant business left. Surely nobody wants that.

Thursday, 6 May 2021

George Monbiot blames the government for rising obesity levels – there’s a simpler explanation

First published in Spectator Health in August 2018

George Monbiot has written a curate’s egg of an article for the Guardian on the subject of obesity. Struck by the near-total absence of fat people in a photo of Brighton beach in 1976, he wondered whether the rise of obesity in the intervening years was the result of more calories in or fewer calories out.

What he discovered came as a shock to him. His first revelation will be no surprise to readers of this blog: calorie consumption has fallen over time. Thanks to the National Food Surveys, we have a treasure trove of information going back to 1940. It shows that the average Briton was consuming more than the modern recommendation of 2,500 calories a day during the war. This rose after 1945, peaking in the 1960s, and falling thereafter. Average daily calorie consumption fell from 2,850 in 1970 to 2,560 in 1980. By 2011, it had dropped to 2,269. Figures from the National Diet and Nutrition Survey, which began in the 1980s, tell much the same story.

These surveys have raised concerns about mismeasurement. We know that people under-report what they eat and that fat people under-report more than thin people. In 2016, Public Health England hired the Behavioural Insights Team to look into this. Sure enough, they found evidence that people under-reported calorie intake and that the scale of under-reporting had risen over time, but even after correcting for this, they found that we are consuming fewer calories than we did in the 1970s.

All the evidence points in the same direction. Average calorie consumption – and, indeed, sugar consumption – is lower today than it was in the 1970s when obesity was relatively rare. The only way to deny this is to dismiss decades of research as worthless rubbish. That is not a good look for an empiricist and it is to Monbiot’s credit that he does not do so.

If we are not consuming more calories then the rise of obesity must be due to us burning fewer calories off, right? Not so fast, says Monbiot. He offers evidence that children are doing just as much exercise as ever and that people in poor countries burn the same number of calories as people in rich countries.

So what is the answer? Alas, this is where Monbiot’s article descends into gibberish. If you’re familiar with his oeuvre, you won’t be surprised to hear that the blame lies with those nasty corporations. They use advertising to ‘overcome our resistance’. They ’employ an army of food scientists and psychologists to trick us into eating more than we need’. They ‘discovered our weaknesses and ruthlessly exploit them.’

This is all standard Guardian banter but it doesn’t make any sense in the context of Monbiot’s article. It is almost as if – perish the thought – he decided what his conclusion was going to be before he began his research.

Even if everything Monbiot says about ‘Big Food’ is true, even if he is right when he says that ‘the opportunities to load our food with sugar have boomed’, we are still faced with the inescapable fact that we are consuming less sugar and fewer calories than we did in the glorious summer of 1976. As far as I can tell, Monbiot does not subscribe to magical thinking about particular types of calorie. His explanation therefore explains nothing.

So what is the real answer? There are factors that Monbiot does not mention, such as the rise of central heating and the decline of smoking, which are likely to have had some effect, albeit only on the margins. It is possible that future research will find that some unsuspected biological factor has also played a role. And it is important to remember that averages do not tell the whole story. It would be an ecological fallacy to assume that everybody is eating less just because average consumption has fallen.

Nevertheless, it is puzzling, to say the least, that the rate of obesity could rise so sharply if calorie consumption has fallen and people are as physically active as they have ever been. But this is where Monbiot makes his mistake. Physical activity has declined and his slivers of evidence to the contrary do not stack up against the facts. Public Health England says that levels of physical activity have dropped by a quarter since 1961. The World Health Organisation says that western countries have seen ‘decreased physical activity levels due to the increasingly sedentary nature of many forms of recreation time, changing modes of transportation, and increasing urbanization.’ Harvard School of Public Health says that: ‘Physical activity levels are declining’ and that ‘this decline in physical activity is a key contributor to the global obesity epidemic’.

Physical activity is not always easy to measure and it is often confused with leisure time exercise, but there should be little doubt that we are burning off fewer calories than ever in our day to day lives.
Britons are walking less (from 255 miles per year in 1976 to 179 miles in 2010) and cycling less (from 51 miles per year in 1976 to 42 miles in 2010). This is true of both adults and children.

Unsurprisingly, people who drive to work are fatter than those who go by foot or by bicycle. And when we get to work, we are more sedentary than ever, as Tim Olds notes:

In the 1960s, half the jobs in private industry in the United States required at least moderate-intensity physical activity, compared to less than 20% today.
Work in factories and farms has given way to office work, and that has amounted to over 400 kilojoules less each day that adults expend at work. This difference alone results in a weight increase of about 13 kilograms over 50 years, which pretty closely matches actual changes in weight.

Only 18 per cent of British adults report doing any moderate or vigorous physical activity at work while 63 per cent never climb stairs at work and 40 per cent spend no time walking at work. Outside of work, 63 per cent report spending less than ten minutes a day walking and 53 per cent do no sports or exercise whatsoever.

This trend is confirmed by the National Food Surveys, which occasionally allude to the fact that the rise of office work resulted in people not needing to eat so much. As early as 1962, they reported that:

 ‘energy requirements have decreased in all regions … The decrease in calorie requirements is greatest in Classes A2 and B, and is partly explained by the increasingly sedentary nature of their occupations’. In 1971, they mentioned the ‘continuing decline in energy needs as work becomes less strenuous.’

On average, declining energy needs have resulted in declining energy consumption, but not for everybody. Hence obesity. It is easier than ever to get fat, not because we are eating more but because physical activity has been engineered out our lives. It is trivially true to say that obesity is caused by eating too much, but in relation to what? If we want to understand what has changed at the macro level in the last fifty years to drive up rates of obesity, we must first acknowledge that ‘calories in’ have not gone up. And once we accept that, there is only one credible explanation left: ‘calories out’ have gone down.

Tuesday, 4 May 2021

E-cigarettes above Ebola? How the WHO lost the plot

First published in Spectator Health in November 2016

How do you deal with a man who likens himself to Hitler, describes the murder of children as ‘collateral damage’, slaughters thousands, and says he’s happy to slaughter three million more?
If the man is Rodrigo Duterte, president of the Philippines, and you are the head of the World Health Organisation’s anti-tobacco division, you will send your personal congratulations. Never mind that Duterte’s indiscriminate shoot-to-kill policy for drug users has brought him to the attention of the International Criminal Court. Duterte has recently introduced a smoking ban and that, it seems, is enough for him to be embraced by the public health community.

A total lack of perspective? Perhaps, but an inability to look beyond petty lifestyle regulation has become the WHO’s calling card. Take North Korea, for example. Amnesty International says that this totalitarian hellhole is ‘in a category of its own when it comes to human rights violations’, but when WHO director-general Margaret Chan visited the country in 2010, she commented favourably on its low rate of obesity.

When the Ebola epidemic began in October 2014, Chan issued a statement saying that she was ‘fully occupied with coordinating the international response to what is unquestionably the most severe acute public health emergency in modern times.’ This was not entirely true. In reality, she was at a WHO conference in Moscow denigrating e-cigarettes and praising Vladimir Putin for his commitment to public health. Malaysian Airlines Flight 17 had been shot down above Ukraine only two weeks earlier.

Rodrigo Duterte, Kim Jong-un and Vladimir Putin. Is there any politician too brutal for the WHO so long as they take a firm line on fizzy drinks and smoking in bars? As international organisations go, this lot make FIFA look like the Girl Guides.

The WHO has been strongly criticised for its feeble response to the Ebola outbreak. There is little doubt that it was ill-prepared for the epidemic, which killed over 11,000 people, but then dealing with contagious diseases in poor countries no longer seems to be the WHO’s priority. Today, its main focus is tackling ‘non-communicable diseases’ and the lifestyle choices associated with them. To that end, the agency has produced reports in the last few weeks calling on governments to introduce taxes on sugar, bans on online food advertising and bans on e-cigarettes. It has previously invested its resources in campaigning against the depiction of smoking in films and for a ban on smoking outdoors; it was by complying with the latter demand that Rodrigo Duterte gained the agency’s respect.

WHO documents about nanny state issues are often published anonymously but when the authors can be identified they are almost invariably from the rich West and the quality of evidence they contain is rarely worthy of an august UN institution. Last month’s report on food taxation, for example, failed to provide any credible evidence that tax has been successfully used to improve health anywhere in the world and its claim at the weekend that vaping does not help smokers quit laughs in the face of the evidence.

Evidence aside, it is questionable whether the WHO should be using its limited resources to pester westerners about their lifestyle choices. When pressed, the agency justifies its approach by pointing out that more people die of non-communicable diseases than die of infectious diseases. This is true, and it is a jolly good thing. It is a mathematical certainty that non-communicable diseases will rise as contagious diseases decline, but contagious diseases tend to kill the young while non-communicable diseases tend to kill the old. It takes a moral imbecile to view the death of an elderly person from cancer no differently to the death of a child from malaria.

Public health used to mean medicine, vaccinations, quarantine and environmental protection — all actions that had to be taken collectively. Increasingly, it has come to mean regulation of personal behaviour, something that individuals are capable of handling themselves. The WHO has embraced the new definition of ‘public health’ wholeheartedly, but fate keeps conspiring to remind it that the original mission remains unfulfilled. Margaret Chan’s attack on e-cigarettes in Moscow in front of an audience of true believers (the media were banned) while Ebola ravaged Africa was a stark illustration of the difference between the health concerns of the rich world and those of the poor.

The organisers of that conference must have cursed their bad timing and hoped for better luck when they organised a follow-up conference for 2016. That conference got underway this week with e-cigarettes top of the agenda. The WHO’s preference is for governments to ban them outright but if prohibition is not feasible it at least wants a ban on vaping indoors to protect bystanders from the mythical threat of secondhand vaping. It is grimly ironic that the conference is being held in Delhi where a thick haze of smog has suffocated the city for several days. Levels of particulate matter are currently 90 times higher than the recognised safe level.

While the delegates inside chatter about plain packaging, film censorship and e-cigarettes, the city outside will serve as a potent reminder that there is still real public health work to be done.