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Trevor Hancock: The sickening side of the food industry

A 2018 study found unhealthy eating in Canada resulted in direct health care costs of $5.1 billion and indirect costs (due to early death or disability) of $8.7 billion
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A 2019 study of trends in fast-food offerings in the United States from 1986 to 2016 found “broadly detrimental changes in fast-food restaurant offerings over a 30-year span including increasing … portion size, energy, and sodium content,” writes Trevor Hancock. CORPSE REVIVER VIA WIKIMEDIA COMMONS

Last week, I noted the private sector is the key player in the provision of a healthy diet. But the food industry also makes a great deal of money from the production and marketing of unhealthy food. It is estimated that globally, unhealthy diets account for about 11 million premature deaths annually.

The toll in Canada is also large: A recent Canadian study noted the dominant Canadian dietary pattern is “high in fast foods, carbonated drinks, refined grains, solid fat, and processed meat” and found that “poor dietary pattern is the leading risk factor for loss of life years at the national level,” ahead of smoking, physical inactivity, and alcohol consumption.

The study looked at the effect of five different healthy diet patterns (e.g. the Mediterranean diet) compared to eating the usual Canadian diet. Depending on which healthy diet pattern was being examined, between a quarter and nearly 40 per cent of all deaths among Canadian men and between 9 and 23 percent of deaths among women “were attributable to poor dietary patterns.”

The economic costs are also very large. A 2018 study looked at the costs of unhealthy eating in Canada; our collective failure to meet recommendations for five protective foods (vegetables, fruit, whole grains, milk, and nuts and seeds) and three harmful foods (processed meat, red meat and sugar-sweetened beverages).

The authors found this resulted in direct health care costs of $5.1 billion and indirect costs (due to early death or disability) of $8.7 billion. But that is an under-estimate because the costs of some chronic disease were not included, nor, importantly, did they include the costs associated with salt, fibre or fat.

It’s not as if we don’t know what makes for a healthy diet. The revised Canada Food Guide, issued in 2019, focused on a more plant-based diet, more whole grains, replacing meats, poultry and dairy products that are high in saturated fat, free sugars or sodium with healthier, less salty, sweet or fatty products, including plant-based protein foods, and reducing our intake of highly processed products and sugary drinks.

And yet large parts of the food industry are dedicated to producing and selling precisely the unhealthy diet — high in fast foods, carbonated drinks, refined grains, solid fat, and processed meat — that we know is causing all these deaths, illnesses and costs. In fact, they spend a huge amount of money on marketing these products, and as I will discuss next week, lobby energetically to prevent changes that would be good for health but perhaps bad for their bottom line.

A 2022 study of food and beverage advertising in Canada noted such marketing “has been identified as a powerful determinant of dietary intake and weight.” The researchers found that in 2019 “an estimated $628.6 million was spent on … food and beverage advertising in Canada”, two thirds of which was on television. It probably won’t surprise you to learn that 87 per cent of that advertising was for “products and brands classified as ‘unhealthy,’ ” while only 2.1 per cent was spent on marketing fruit and vegetables and less than one per cent on water.

Also unsurprisingly, a 2019 study of trends in fast-food offerings in the United States from 1986 to 2016 found “broadly detrimental changes in fast-food restaurant offerings over a 30-year span including increasing … portion size, energy, and sodium content.” It is not likely to be very different here in Canada.

Indeed, a recent study found that while sodium (salt) intake in Canada is down from 2004, it is still well above the level needed for good health. Moreover, the voluntary sodium reduction strategy adopted by Health Canada in 2012 was ineffective, with only 13 of 94 food categories meeting the 2016 sodium reduction targets.

Also unsurprisingly, a 2015 review by the respected Cochrane Collaborative found “people consistently consume more food and drink when offered larger‐sized portions, packages or tableware than when offered smaller‐sized versions.”

In short, a large part of the food industry is producing and marketing an unhealthy diet, at great cost to the health of Canadians. Moreover, as I will discuss next week, the way our food is grown is also often harmful to both the planet and to people.

thancock@uvic.ca

Dr. Trevor Hancock is a retired professor and senior scholar at the University of Victoria’s School of Public Health and Social Policy

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