We need preventative measures focused on helping the Scottish population to eat better

In Scotland, equality and poverty are manifested through food into health inequalities.

What needs to be done:

The Government’s focus has been disproportionately on the individual, and changing individual choices and behaviours through public education and campaigns – but for people to start to make different food choices, we need to create a material and social environment to enable and support these choices (taking the ISM framework as a starting point). The government spends huge amounts on dealing with the consequences of poor health; preventative measures focused on helping the Scottish population to eat better would be money well spent.

 

To promote a food system that reduces health inequalities, the Scottish Government could:

  • Lead by example with all food served in the public sector meeting the healthy eating aims set out for our national diet and sustainably sourced
  • Support training and development for people working with food and stimulate new food based start-ups, especially ones that deliver sustainably produced, healthy food.
  • Extend the healthy start voucher scheme to subsidise fruit and vegetables for all low-income families.
  • Support primary care teams to form an integral part of improving public nutrition, just as they have helped to reduce smoking.
  • Support a network of well-trained community growing advisors. These advisors could work to implement the local authority’s ‘food growing strategy’ (which must be developed under the Community Empowerment Act) to double urban production of fruit and vegetables.
  • Exempt fresh fruit and vegetable shops on the high street from business rates, providing training for staff to work as informal providers of nutritional advice and encouragement.
  • Exempt restaurants using predominantly local produce and serving healthy food from business rates.
 

 

Why the contribution is important

 

The issues:

  • Our levels of diet-related ill health and obesity continue to rise (incl. diabetes, cancer and cardiovascular diseases)
  • Our progress in meeting our national dietary goals (eating more fibre and fruit and vegetables and less sugar, salt and saturated fats) remains extremely poor
  • Poverty greatly impacts people’s ability to feed themselves and their families well: Today a healthy diet is financially inaccessible for many in Scotland. A recent UK study found that on average healthy foods are approximately three times more expensive than less healthy foods per calorie. Unable to afford healthy foods – or the fuel to cook them – low-income households consume more highly-processed foods high in sugar, fat and salt, which also tend to be marketed towards such groups. Health inequalities are marking ever-deepening lines through Scottish society.

 

by NourishScotland on January 27, 2016 at 10:19AM

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Comments

  • Posted by ihewitt March 08, 2016 at 20:37

    I believe that there is significant untapped potential in the use of diet in the treatment and prevention of disease and that it could contribute towards solving the long term challenges in funding health and social care with an aging population. Current national guidelines do not reflect the best available evidence on the effects of diet on health. In addition, most of the research that is conducted in this area tends to be in the form of observational studies, which cannot prove cause and effect, resulting in the conflicting headlines we frequently see in the press.

    The effects of diet on cardiovascular disease were studied in a large randomised controlled trial (the PREDIMED study) which compared a mediteraneon diet that encouraged the intake of nuts or olive oil with a low fat diet. There was a significant reduction in rates of cardiovascular disease aswell as several secondary outcomes such as breast cancer and type 2 diabetes in the mediteraneon diet group. The results of this study are also supported by data from other smaller trials and observational data. Despite this, our current national dietry guidance (the eatwell plate) includes high fat products such as olive oil and nuts in the same category as added sugars (i.e foods where intake is discouraged). Clearly this guidance does not reflect the current best evidence. I believe that the Scottish government should change our national guidance so that intake of fat from olive oil and nuts is encouraged and widely advertise this change and the downsides of low fat foods (i.e they are often supplanted with sugar). Such a change has the potential to improve health outcomes and save money for the NHS.

    I believe that there is potential to significantly improve on the outcomes discussed above. There is observational evidence to indicate that rates of chronic disease are significantly lower prior to adoption of a westernised diet. However, there isn't currently clear evidence about which elements of the western diet are responsible for this change. Theories include increased intake of meat, increased intake of refined carbohydrates including white flour / sugar or increasing intake of processed food. Most of the research that is carried in the field of diet out takes the form of observational studies as these are cheaper to run. However, these studies cannot be used to reliably prove cause and effect. Randomised trials like the one discussed above can do this but it is difficult to get funding to carry these out for diet as there no drug company etc who stands to make a profit from the outcome. To resolve this, I suggest that the Scottish government should form a public body that aims to gradually improve our guidance on diet by conducting randomised controlled trials to answer some of the important questions around diet and health. While this would cost money to implement there is potential for it to save money for health and social care in the long term.

    If one or both of the above suggestions could be implemented I believe there could be significant benefits both for the health of the population and public finances.
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