Sunday, 31 January 2016

Scottish obesity babble

The latest in a long line of doomed obesity predictions in the Herald...

If things continue at the current rate, 40% of the Scottish population will be obese 15 years from now. 

So what is the current rate? According to the Scottish government...

Between 1995 and 2008, adult (16-64) overweight (including obesity) and obesity rates increased by 10.5% and 8.5%, respectively. However, no further increases have been observed since.

And amongst children?

...the proportion of girls meeting the healthy weight criteria has been relatively stable between 1998 and 2013. Contrastingly, healthy weight prevalence in boys decreased by more than 9% between 1998 and 2008, although it has since increased again.


So, in summary...

Following significant increases between 1995 and 2008, adult overweight and obesity rates in Scotland have since stabilised

The current rate is therefore zero. It could go up. It could go down. But if anyone wants to bet that it will be 40 per cent by 2031, my door is open if your wallet is.

Friday, 29 January 2016

VIDEO: The End of Boozy Britain?

From last year's Battle of Ideas, the panel discussion asking whatever happened to Boozy Britain?




Featuring:

Daisy Blench
policy manager - alcohol policy and responsibility, British Beer & Pub Association

Neil Davenport
writer; teacher; contributor, spiked

Dr Clare Gerada
GP; past chair, Royal College of General Practitioners

Sian Jarvis
managing director, Jarvis & Bo Communications; former director general of communications, Department of Health

Christopher Snowdon
director, lifestyle economics, Institute of Economic Affairs; author, The Art of Suppression

Chair
Alan Miller
chairman, Night Time Industries Association (NTIA)

... and a surprisingly large number of young teetotallers in the audience.


If you like this, you might like Planet of the Vapes from the same festival.

Thursday, 28 January 2016

A confederacy of obesity dunces

If you want to understand how the obesity discussion in the UK has descended into pseudo-scientific gibberish in the last few years, the infographic below offers a disturbing guide. These are the most influential Tweeters on the subject according to this website. I can well believe it.

Click to enlarge, but some familiar faces stand out. Leaving aside the handful of health organisations and few relatively sensible academics, here's a who's who...

Jamie Oliver. Millionaire TV chef. Publicity hunter. Jumped on the anti-sugar bandwagon last year.

Aseem Malhotra. A strong contender for the most stupid person I have ever written about. Desperate for fame. Now firmly entrenched in the low carb/Atkins cult.

Simon Capewell. Taxpayer-funded anti-everything authoritarian. Gets a chimpanzee to work his Twitter feed, at least that's what it looks like.

Sarah Wollaston. The House of Common's nanny-in-residence. Has never seen a tax or ban she didn't like.

Action on Sugar. Previously known as Consensus on Action on Salt and Health. Former home of Aseem Malhotra, now home to the genuinely terrifying Graham MacGregor and the fool Capewell. Spends a lot more money than it brings in.

Food Revolution. The political wing of Jamie Oliver Inc.

World Cancer Research Fund. Respectable sounding organisation which is actually the academic equivalent of the Daily Mail. Issues reports claiming that virtually every food on the planet either causes cancer or prevents it.

Children's Food Campaign. Pressure group that could fit in a phone box. Leading campaigners for a soft drink tax and mates with the fat-tongued one.

Zoe Harcombe. Multiple diet book entrepreneur, now firmly on the low carb gravy train.

Tim Noakes. Obsessive Atkins/low carb/banting campaigner, author and entrepreneur. Wrote the 'exercise won't help you lose weight' op-ed with Malhotra last year. Hauled up before the Health Professions Council for telling a mother to wean her infant on a low carb/high fat diet.

Andreas Enfeldt. Another Atkins Diet entrepreneur. You can join his website for nine bucks a month.

Jenny Rosborough. Campaign manager at Action on Sugar.

Sugar Coated. Twitter feed for yet another anti-sugar documentary. Twitter profile literally says 'Is sugar the new tobacco? #toxicsugar #sugartax'

Larry Diamond. Never heard of him before but his Twitter profile carries the telltale #LCHF hashtag that is the mark of the Atkins Diet cult member.

Hannah Brinsden. Never heard of her either but her Twitter profile informs us that she is 'challenging corporate power and Big Food'. With this juvenile anti-capitalism, she's an ideal candidate to work in 'public health' which, of course, is what she does.


Note that this is not hand-selected group of somebody's favourite Tweeters. It is based on an analysis of the most popular obesity-related Tweeters in a three month period. Interestingly, the supposedly all-powerful food industry doesn't have any of its members amongst the big hitters, but nor does the mainstream scientific community.

It is quite remarkable, and yet little remarked upon, how much the low carb/high fat faddists have taken over the obesity debate (sugar is, of course, a carbohydrate). If this network of Atkins zealots and anti-sugar fanatics is really what is driving policy, it is little wonder that it has become almost impossible to inject science and evidence into it.

Wednesday, 27 January 2016

Plain packaging for food and drink - the vultures circle

A quick round up of news from half way down the slippery slope. First, from the Canadian Journal of Public Health...

Alcohol warning label perceptions: Emerging evidence for alcohol policy.

OBJECTIVES:

Patterns of alcohol and cigarette use and abuse can be considered parallels due to their similar social, biological and epidemiological implications. Therefore, the cross-fertilization of policy research, including health warnings evidence, is justified. The objective of this study was to apply the lessons learned from the tobacco health warnings and plain packaging literature to an alcohol packaging study and test whether labelling alters consumer perceptions.

METHODS:

Ninety-two adults were exposed to four labelling conditions of bottles for a famous brand of each of wine, beer and hard liquor. Participants were randomly assigned to one of four labelling conditions: standard, text warning, text and image warning, or text and image warning on a plain bottle. Participants then expressed their product-based (i.e., evaluation of the products) and consumer-based (i.e., evaluation of potential consumers of the products) perceptions in relation to each label condition and were asked to recognize the correct health warning.

RESULTS:

As expected, participants perceived bottles with warnings less positively as compared to standard bottles in terms of product-based and consumer-based perceptions: plain bottles showed the most consistent statistically significant results, followed by text and image warnings, and then text warnings in pair-wise comparisons with the standard bottles. Some support for the impact of plain packaging on warning recognition was also found.

CONCLUSION:

Unlike previous studies, this study reveals that health warnings, if similar to those on cigarette packs, can change consumer-based and product-based perceptions of alcohol products. The study reveals the importance of serious consideration of stringent alcohol warning policy research.

Secondly, from a forthcoming obesity conference...

Effects Of Plain Packaging, Warning Labels, And Taxes On Young People's Preferences For Sugar-sweetened Beverages: Results From An Online Experimental Study

Consumption of sugar-sweetened beverages (SSBs) is associated with obesity, diabetes, heart disease and dental caries.

Our aim was to assess effects of plain packaging, warning labels, and a 20% tax on SSB preferences, beliefs and purchase probabilities amongst young people. A 2 x 3 x 2 between-group experimental study was undertaken, via an anonymous online survey. 604 young New Zealanders aged 13-24 years who consumed soft drinks regularly were recruited. Participants were randomly allocated to view one of 12 experimental conditions, specifically images of branded versus plain packaged SSBs, with either no warning, a text warning, or a graphic warning, and with or without a 20% tax. Perceptions of the allocated SSB product and of those who might consume the product were measured using seven-point Likert scales. Purchase probabilities were measured using 11-point Juster scales.

All three intervention scenarios had a significant negative effect on preferences for SSBs... Plain packaging and warning labels could significantly reduce adolescents’ and young adults’ preferences for and likelihood to purchase SSBs, and are therefore likely to reduce consumption.

And then there's this from Food Quality and Preference...

Public policy makers have recently recommended deactivating the marketing functions of unhealthy food packaging by enforcing the use of plain food packaging.

That can't be right, surely? Those good, honest public health professionals promised this would never happen.

Tragically, the Food Quality and Preference study found that plain packaging for snacks made people consume more of them. Perhaps that explains why cigarette sales rose after plain packaging was introduced in Australia.

Never mind though. I'm sure future studies will iron out that little problem and come to the 'right' conclusion, as the studies into booze and soft drinks above did.

The evidence is starting to mount isn't it, nonsmokers? Soon it will be 'overwhelming' and politicians will be forced to act. I can hardly wait to to see the look on your faces when you finally realise that freedom is indivisible.


Tuesday, 26 January 2016

A tobacco levy won't work

One of the consequences of David Cameron's flip-flopping and indecision on issues like plain packaging and the sugar tax is that campaigners won't drop their demands even when the government has said it won't meet them. They know that there is always a chance that Cameron will suddenly change his mind.

So it is with the 'tobacco levy', a hare-brained scheme to claw another £500 million out of the tobacco industry (and therefore out of smokers). It was mooted by the Tories (and Labour), but the treasury later conceded that it was impractical. Anyone who has considered the policy for more than five seconds can see that it has intractable problems.

Foremost amongst them is the awkward fact that most tobacco companies are not actually based in the UK. The UK government cannot demand that a company that is headquartered in Switzerland - as JTI and Philip Morris are - hands over an arbitrary sum of money from its profits. It would be like the Japanese government telling Greggs to give it a profit share. It can't be done.

There are still two large tobacco companies headquartered in Britain - BAT and Imperial - but I doubt they will hang around for long if venal politicians start ransacking their profits. In many respects, it is a mystery why they have hung around for so long. Plenty of virtue-signalling politicians would be happy for them to slip off to Bermuda or wherever, taking their jobs with them. A raid on their post-tax profits would surely the the last straw. 

Windfall taxes are pretty immoral at the best of times. As I have said before, they are the mark of arbitrary and capricious government. Leaving aside the ethics, they only work if the company you are looting is (a) based in the country, and (b) cannot leave the country.

The tobacco levy is a stupid and unworkable idea. Naturally, then, the 'public health' lobby are very keen on it and have made another PR push today. Their new excuse for wanting it is to finance smoking cessation services.

Cancer Research UK is today (Tuesday) calling on the Government to make the tobacco industry pay for the damage it causes and help reduce the number of people killed by its deadly product.

Earlier this month a report published by Cancer Research UK revealed that cuts to public health funding mean local Stop Smoking Services are being closed down.

Indeed it did. What it failed to mention was the obsolescence of these vastly expensive and largely ineffective services. The Local Government Association released a surprisingly forthright statement which said, in effect, that it was about time funding was cut.

Responding to Action on Smoking & Health (ASH) report on budget cuts to stop smoking services, Cllr Izzi Seccombe, Local Government Association Community Wellbeing spokesperson, said:

Since the advent of e-cigarettes and campaigns such as Stoptober, we have seen the number of users of smoking cessation services fall, while the population of smokers left is now more challenging to get to quit. This means councils are re-evaluating what they do on tobacco control and how to be more effective.
“Councils remain committed to helping smokers quit, however they face significant cuts to public health budgets this year, and spending large volumes of money on a service people are not using will fast undermine the cost-effectiveness of providing it.”

The CRUK press release continues:

Smoking continues to kill more than 100,000 people in the UK every year.

Merely as an aside, this 100,000 figure has been used since the mid-1980s when the smoking rate was very much higher than it is today. Are we to assume that halving the smoking rate has had no effect on the number of people dying from smoking-related diseases?

Internationally, the tobacco industry makes around £30 billion in profit.

Assuming this figure is roughly correct, the entire global tobacco industry makes £30 billion a year from 1.5 billion smokers. In Britain, home to less than one per cent of the world's smokers, the government makes £12 billion from tobacco duty. Who is really profiting from this product? (Answer: nonsmokers.)

CRUK then show us a cute little graphic showing how terribly straightforward their proposal is.



Note that it bypasses all the practical problems by simply saying 'The government can pass a law'. This could be the slogan of every ban-everything pressure group on the planet. Unfortunately for them, it's not actually true in this instance and so the plan falls at the first hurdle.


Monday, 25 January 2016

Action on Fruit



It had to happen. Once the hysteria about sugary drinks took hold, it was only a matter of time before fruit juice came under attack. From there, it was only a short step to attacking fruit itself. The Atkins Diet fanatics who are the grass roots of the anti-sugar panic have a particular bee in their bonnet about fructose because they once saw a video by Robert Lustig. Lustig's bête noire is high fructose corn syrup, but fructose is obviously in fruit; the word means 'fruit sugar'.

A campaign against fruit is therefore the logical conclusion of the crusade against sugar, but since demonising fruit would test the patience of all but the most credulous members of the public, few campaigners have gone down that road.

One of the few is the chap in the video below, Garry Fettke, an Australian orthopaedic surgeon who runs a website called No Fructose. He says that fruit has been pushed on the public by Big Food using 'one of the greatest marketing campaigns of the last 25 years'. He says we have been 'fooled by nature and fooled by the food industry'.

It is, by any standards, a remarkable speech. Like many people who fear the modern world, he relies heavily on appeals to nature. Low carb people have a thing about hunter-gatherer societies and they assume, quite bizarrely, that 'natural' means 'healthy'. Since neanderthal man only had to access to fruit for a few weeks each year, they assume that seasonal fruit is probably OK. The rest of the year we should only eat buffalo or something.

Every food faddist needs a catchphrase. Lustig's is 'sugar is alcohol without the buzz'. Malhotra's is 'fat is your friend'. Quite wonderfully, Fettke's is 'fruit is confectionery on a tree'. He begins with what he calls 'a little bit of history' but which is actually the biblical story of Adam and Eve.

'Adam and Eve started it all when they plucked that apple off the tree and that turned us from immortal to mortal. That piece of fruit was advertised by the serpent - the snake - to be better than it actually was and we continue to hear that advertising message. Fruit continues to be advertised as better than it actually is... it advertises itself by being brightly coloured, shiny, sweet and attracts the wild life.'

Later in the talk he makes a reference to that other great historical figure, Snow White, but the real hilarity comes after 25 minutes when he starts favorably comparing Coca-Cola to various fruits. He is right to say that sugar content by weight is the same or higher in many popular fruits, but that is only shocking if you consider a can of Coke, with its 139 calories, to be terribly dangerous.

This is what the 'public health' lobby does believe, however. They usually try to wriggle out of the comparison by muttering something about fibre in fruits being good for you or by making a scientifically meaningless distinction between added sugar and intrinsic sugar. Fruit does indeed contain fibre - although there are more plentiful sources of fibre available - but it is a sideshow if you believe that sugar is toxic/addictive/poisonous etc. Fettke is the one being logically consistent here and Action on Sugar are not. By being consistent he inadvertently highlights the lunacy of the anti-sugar mania.

Confectionery on a tree?! What a time to be alive.
 




Saturday, 23 January 2016

The Guardian resurrects the Boozy Britain moral panic

The Guardian has had one of its spasms today with a series of articles attempting to revive the Boozy Britain panic. The newspaper is indistinguishable from the Daily Mail on such occasions. Its front page story reads like a press release from the Alcohol Health Alliance. That's because it is.

Earlier this week the Australian neo-temperance lobby got some headlines when it pointed out that a relatively small number of drinkers account for a large proportion of alcohol sales. This is hardly surprising. It is the same in most industries and is known as the Pareto Principle.

Seeing the news coverage in Australia, British wowsers made their own back-of-the-envelope calculation and alerted the Guardian's Sarah Boseley who lapped it up.

Exclusive: Firms claim to support responsible drinking, yet data shows those who consume at risky or harmful levels account for 60% of sales in England

Note the implicit accusation of dishonesty here, as if the statistic somehow proves that the 'firms' do not support responsible drinking. It is, of course, entirely up to the individuals how much they choose to drink and they will consume whatever quantity they like regardless of the views of the manufacturer.

The alcohol industry makes most of its money – an estimated £23.7bn in sales in England alone – from people whose drinking is destroying or risking their health, say experts who accuse the industry of irresponsible pricing and marketing.

That £23.7 billion isn't really the industry's money though, is it? About £7 billion is tax, for a start. Only a fraction of it is profit.

While the industry points to the fact that most people in the country are moderate drinkers, 60% of alcohol sales are either to those who are risking their health, or those – labelled harmful drinkers – who are doing themselves potentially lethal damage, figures seen by the Guardian show.

This claim is based on the government's scientifically insupportable drinking guidelines which classify moderate drinkers as hazardous drinkers. 19 per cent of Britons supposedly fall under that category. The Guardian doesn't bother to mention that this percentage has been falling for years. (It will soon rise now that guidelines have been lowered - that was the whole point.) In any case, it should not be surprising that people who drink quite a bit consume a larger proportion of the nation's alcohol than people who don't drink very much.


Separate work in progress from Sheffield University helps to establish the value of this custom to the industry. In 2013, the data shows, 38.2% of the value of alcohol sales in England came from risky drinkers and 24.5% from harmful drinkers. Industry sales in the UK were £45.5bn in 2013.

The Sheffield University researchers are not named but I'll take a wild stab in the dark and guess that they are the same small team of academics who came up with the hopeless minimum pricing model and the laughable new drinking guidelines. If so, how nice of them to share unpublished research with a hardcore anti-alcohol lobby group for propaganda purposes, just as they shared unpublished research with Panorama for propaganda purposes (research that was so utterly inept that the programme had to be re-edited to remove it.) It's almost as if those guys are activists rather than impartial academics, isn't it?

It's not too difficult to estimate how much alcohol 'hazardous drinkers' consume so even the Sheffield mob have a good chance of not totally ballsing up the figures. All the numbers in the Guardian article are in the same ballpark as one would expect if the drinks industry was like any other industry. About 25 per cent of drinkers are buying about 70 per cent of the drinks. The question is 'So what?'

Katherine Brown, director of the Institute of Alcohol Studies, said: “It comes as no surprise to learn the drinks industry relies on excessive consumption of alcohol to boost its profits. Why else would alcohol producers spend millions of pounds on advertising each year encouraging people to drink more...

Aside from the fact that it is illegal for alcohol advertisements to 'encourage people to drink more', the 'why else would they do it?' argument against advertising is just dumb, as I explained on the IEA blog recently...

‘If advertising doesn’t work, why do companies spend so much money on it?’ This is the zinger that is supposed to end all argument about whether marketing increases the consumption of certain products. The products under discussion are usually things that one side of the argument would prefer people did not buy and, to that end, think should not be advertised.

One can reply by saying that advertising is not coercive. One can point out that no amount of advertising can sell a bad product. One can argue that advertising is primarily aimed at making users of a product switch to a different brand. You can explain any of this, but the retort will always be the same. “Ah, but if advertising didn’t work, they wouldn’t do it!”

For example, an organisation called Alcohol Action Ireland currently wishes to ban alcohol sponsorship in sports. ‘Alcohol sponsorship of sports works in terms of increasing sales and, as a result, alcohol consumption,’ it asserts. ‘If it didn’t the alcohol industry simply would not spend so much money on it.’ They assume that the drinks industry hopes and expects advertising to increase consumption.

However, advertisers are not spending their money as an industry, but as rival firms trying to sell their own brands. Their battle for market share may or may not coincide with a growing market for alcohol as a whole, but an individual company does not need a growing market in order to become more profitable. There are plenty of heavily advertised products in markets that are static or declining. Imagine ‘Toilet Paper Action’ Ireland declaring that ‘Toilet paper advertising works in terms of increasing sales and, as a result, toilet paper consumption. If it didn’t Andrex simply wouldn’t spend so much money on it.’ Such a statement would be patently absurd.

It also happens to be a fact that alcohol advertising does not make people drink more. It only encourages people to buy different brands (or stay loyal to the brand they already buy).

It is futile trying to explain this to the morons of 'public health'. They fundamentally do not understand how business works. Speaking of morons, look who else the Guardian approached for a comment...

Gerard Hastings, professor of social marketing at Stirling University, said the data “throws into relief the conflict of interest between industry and public health. Industry is driven by the need to sell as much as it possibly can. Ultimately the marketing department rules the waves.”

No, Gerard. Industry is driven by the need to make as much profit as it possibly can. It can do so when sales are in decline, as has been the case in the alcohol industry for the last decade. It's not about volume, it's about margins. Someone should have explained this to Sarah Boseley before she wrote a front page story that confuses revenue with profit.

Brown said evidence from Canada showed that a 10% increase in alcohol prices led to a 32% reduction in alcohol-related deaths.

Brown is the director of an organisation that used to be called the UK Temperance Alliance. These people say a lot of things, many of them untrue. Journalists are suppose to find out whether the things they are told by lobby groups stand up against the facts. The claim that alcohol-related deaths fell by 32 per cent in Canada is emphatically not true.

Incredibly, this is one of seven Booze Britain articles in the Guardian today. One of them claims that 'up to 35 per cent of A & E visits in the north-east are alcohol-related'. This is based on an unpublished report from another neo-temperance group, the wholly state-funded Balance North East. The 35 per cent figure is at odds with a recent, published study that found the figure in Newcastle to be 12 to 15 per cent. As a rule of thumb, anyone who prefixes a statistic with the words 'up to' is trying it on.

Most of the articles claim that there are more than one million alcohol-related hospital admissions and assert that this has doubled in ten years. This is based on a ridiculously broad definition of 'alcohol-related' which includes primary and secondary diagnoses. As I explained in Alcohol and the Public Purse, secondary diagnoses are more likely to be recorded than in the past and the broad measure gives many false positives...

Under what the ONS calls the ‘broad measure’, there are admissions which involve people who have a partly or wholly alcohol-attributable condition as a secondary diagnosis but who were attending hospital for a condition that was not alcohol-related. For example, if someone who happened to have hypertension went to hospital for treatment of a virus, this would be counted as an alcohol-related admission (or, to be precise, a fraction of an alcohol-related admission) because hypertension is sometimes caused by alcohol use.

Moreover, clinicians are more likely to record a secondary diagnosis than they were in the past, leading to ‘artificial inflation over time due to changes unrelated to the actual occurrence of disease’  and implausibly large increases in putative costs. For example, if taken at face value, the most recent NHS cost estimate showed a 67 per cent rise in the cost of alcohol-related hospital admissions in the space of just three years... These runaway costs, which coincided with a steep decline in alcohol consumption, are an almost inevitable result of including admissions for which alcohol was not the primary diagnosis. It reflects little more than the ageing population, coding drift, and the increased use of hospitals (the number of finished consultant episodes’ in English hospitals for all causes rose from 12 million to 18 million between 2001 and 2013).

The broad measure is so unreliable that the Department of Health no longer uses it. 'Public health' lobbyists still use it because it gives them a bigger number and, as ever, they don't care about the truth.