Tackling Obesity- Any role for Industry?

ST Review Commentary Photo 20 July 2013I wrote this a while back but only contributed it to the Straits Times earlier this week. It was published today with the headline “Food industry must shape up to curb obesity”.

Guess I differ a little from many of my public health colleagues in believing that ‘real’ solutions to the public health challenges of our age can only be solved by engendering the win-win-win outcomes for the public, the government and the industry. The public want better health (At least we hope so!), the government wants to do the right thing and remain government of prosperous nations, and industry, well, it wants to make money. There is nothing wrong with this and we in Singapore with the highest paid politicians and civil servants in the world (‘Work for reward, reward for work’ was the mantra in an article by a prominent civil servant I read many years ago justifying the salary philosophy and structures in government) would be hard-pressed to throw the first stone.

Can we achieve this win-win-win outcome? I think we can, but only if government which is the only player with force of law and regulation is savvy and confident enough to engage with industry, and consumers care enough to make purchasing choices not solely based on individual interests. If this happens, industry can and does transform.

One example from Derek Yach, a member of the PepsiCo Scientific Advisory Board, which I particularly like

I think when Edison turned on the light bulb and created General Electric over a century ago, the first goal was to try and expand as many light
bulb consumers worldwide and increase energy consumption. That was General
Electric then.

General Electric today is a leader in sustainable development and thinking about how to continue to become one of the great profitable companies on the planet. It continues to provide energy but aims to provide it in a different, sustainable way using a different business model. It can happen.


Food industry must shape up to tackle obesity


Obesity has been called the defining issue of our times. In the last thirty years, obesity has almost doubled globally. The World Health Organization calculates that obesity contributes to 44 per cent of diabetes cases and 23 per cent of the incidence of heart disease.
Last year, American researchers declared that obesity added an astounding US$190 billion to the national healthcare bill. In one quirky analysis, the extra weight carried by obese Americans was calculated to account for almost 1 billion additional gallons of petrol, or one per cent of total automobile fuel consumption! Clearly, the impact of obesity is far-reaching.
Food (and beverage) manufacturers have been blamed for this epidemic, with accusations that companies are putting profits before public health. A recent book ‘Salt, Sugar, Fat’ by Pulitzer Prize-winning writer Michael Moss pillories the industry, saying that it has addicted entire populations to fattening food by making them “so tasty, people can’t resist eating them”.

An interesting set of questions then arises: Is the food industry the problem? And can it also be part of the solution? The views on this are polemical. The Lancet Non Communicable Diseases Action Group strongly recommends “Unhealthy commodity industries should have no role in the formation of national or international policy for non-communicable diseases”. The rationale is similar to that applied to the tobacco industry. The Group describes the conflict of interest with public health as “irreconcilable”. Companies maintain their profits only if undesirable public health behaviors persist.

Hence, the Group concludes that government regulations were the only reasonable course of action and that industry should be categorically excluded from involvement in the process. Kelly Brownell of Yale University, one of the most unspoken critics of the food industry writes ominously, “When the history of the world’s attempt to address obesity is written, the greatest failure may be collaboration with, and appeasement of, the food industry”.

Derek Yach, a member of the PepsiCo Scientific Advisory Board, offers an alternative perspective. Citing analogies with the energy sector, he describes how the energy sector had for many years favored quantity over quality. However, recognizing the impact of climate change, the sector realized it had to change its business model.

General Electric today is a leader in sustainable development. It continues to focus on energy generation but in ways that are sustainable and profitable. This needs a totally different business model but it is happening. Companies can and do transform.

Can it happen with food? Let’s look at the automobile industry for some perspective. There were over 54,000 traffic fatalities in America in 1972. Today, the comparable figure is about 33,000, a remarkable 39 per cent decline. The reasons are of course multiple, but experts agree better design of cars and the driving environment have played major roles. Who designs cars? Not the government but automobile companies. Who compels higher safety standards? Not automobile companies but the government. Who looks at the 5-Star Safety Ratings and who pays a premium for safer cars? Consumers like you and me.

Stripped to its essence, the food industry is like any other business. It will do what it has to do to sell more to more people. The key is transformation of the business model. Governments and consumers play critical roles here in shaping the business environment for the food industry. As with the automobile industry, governments should construct regulations based on good science and the public interest whilst recognizing that individual choices matter.

No one would suggest banning cars and forcing citizens to walk everywhere. In the same way, fattening foods cannot be banned or taxed away. But they can be priced correctly to factor in the negative externalities and encourage positive public health behaviors. High taxes on petrol dis-incentivize ‘gas guzzlers’, subsidies encourage sales of hybrid vehicles.
In Singapore, the government has worked with food manufacturers to re-engineer rice noodles to introduce wholegrains. It has also carried out pilot studies to subsidize brown rice in hawker centers and food courts. One new initiative is the ‘Healthier Hawker’ programme launched in 2011.

Under this programme, the entire hawker center commits to offering healthier options. The pioneer ‘Yuhua Hawker Centre’ reported a tripling of sales of dishes made with brown rice and wholegrain noodles. Importantly, earnings went up by at least 10 per cent, thus encouraging hawkers to stick to the programe. It’s business. This year, the health ministry announced another 40 food outlets would be included.

One final comment: It’s important to have a level playing field. While multi-nationals like the Coca Colas and McDonald’s of the world are attractive targets for vilification, their products are not necessarily the only contentious ones out there. A slice of bak kwa contains 370 calories. A can of Coke? 139. Three pineapple tarts have more calories than a McDonald’s apple pie. Boycott local companies like Bangawan Solo or Bee Cheng Hiang anyone?
Businesses will do what’s good for business. It’s up to governments and consumers to make sure what’s good for business is also good for people and good for society. ‘Do well AND do good’ is the mantra in vogue. Empty words in the food industry – unless doing well is only possible by doing good.

Only through adroit public regulation and consumer choice we make can make this happen. Should what Forbes calls the “world’s biggest industry” contribute to addressing “the defining issue of our times”? Yes, but only under the watchful eyes of a government that can balance the diverse stakeholder interests and do what is best for the people.



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