I doubt if many people were surprised to learn that more than half of the experts on the UK government’s nutrition advisory panel (SACN) have links to the food industry, as revealed in a new investigation by the BMJ. Much in the same way we assume the findings of the next Government appointed commission or task force on health and nutrition will be largely ignored by ministers (with maybe 5-10% of the recommendations implemented at best), it’s what we’ve come to expect. 

Not surprising then, but shocking nonetheless. Especially when considered alongside latest data on diet related disease: obesity standing at 28.3% of women and 26.9% of men (up from 13.8% and 10.7%, respectively, three decades ago); deaths from premature heart disease in England at their highest in 14 years, and diabetes cases in the UK at record levels.

Successive governments have grievously abrogated their responsibilities on nutrition and health, resistant to or fearful of acting on the advice of independent experts and preferring to work ‘in partnership’ with the food industry – significant parts of which make products that, to quote Dr Chris Van Tulleken, “are driving early death in a really unpleasant way, and they know it”. So, plenty of hand wringing over soaring health costs and a collapsing NHS but near silence on the fact that the system is designed – or at least destined – to fail.

Of course the epidemic of diet-related disease that is pushing the NHS to the brink doesn’t just have enormous economic impacts, it is also responsible for enormous amounts of human suffering – including among children and teenagers (to which you might also say “and they know it”). 

One of the most striking observations in Chris Van Tulleken’s best-selling book Ultra-Processed People is about the purpose of the “food substances” made by transnational companies – that is, “to create highly profitable products”. This, he says, directly determines the formulation and composition of ultra-processed foods. It’s why cheap bulkers, binders, emulsifiers and flavours are used to replace more expensive traditional ingredients. And it’s the incentive to create ‘hyperpalatable‘ products “that subvert the body’s evolved mechanisms that signal when to stop eating”. 

Lethal cultural norm
Much diet-related disease is increasingly recognised as ‘commerciogenic’ – that is, caused by the pursuit of maximum possible profits. The connection was emphasised this week by the entrepreneur and former Government food tsar, Henry Dimbleby. Responding to the findings of the Darzi Review, which sets out the full extent of the crisis the NHS is facing, Dimbleby says that the “relentless flow of junk food” has become “the lethal cultural norm”.

One of the messages industry now has on constant repeat is that regulation of ultra-processed (or HFSS) food would hit lower income families the hardest. It argues that the foods campaigners are targeting are typically those that are most affordable and accessible to lower income groups – with the inference that regulating them would add to the economic burden on the poorest families. They are less keen to acknowledge that they are also their most profitable products (a 2023 Oxford University study for Bite Back found that two thirds of the profits from the 10 biggest food businesses operating in the UK came from unhealthy packaged foods and beverages), or that people from low-income groups, who get more of their energy intake from ultra-processed food, suffer disproportionately from diet-related disease.

Industry pushback against scientists and campaigners warning about UPFs specifically is steadily being ratcheted up. A paper published by the journal National Library of Medicine details the techniques and tactics being used by transnational companies (TNCs) to undermine the case for regulating the marketing of UPFs. Broadly, these are designed to sustain and protect its markets and profits for the long term. They are all very familiar, but it’s worth summarising the authors’ characterisation of the three main strategies:

Capturing policy – Working to shape policies that favour the industry’s interests, typically making extensive use of below-the-line activities to water down diet-related disease prevention efforts. Engineering ‘policy substitution’ through the promotion of self-regulatory codes of conduct. 

Capturing science – Evidence shaping to make governments disregard legitimate science. Funding research that seeks to obscure public health evidence, disseminating data that favours industry … (and) criticising evidence to emphasise complexity or uncertainty. Making legal threats to individual scientists and or/research bodies and infiltrating public health bodies.

Capturing civil society – Using public-private partnerships, CSR and sponsorship to generate “a smokescreen of goodwill” with civil society, sports groups and community members – helping shift the debate to one that places industry in a more conciliatory light, and as ostensible solution providers. 

If nothing else, the above is a useful reminder of just how pervasive the lobbying and ‘perception shaping’ strategies employed by TNCs and their proxies are.  

Oppose, delay, defer, dilute
Generally campaigners are not calling for a severance of communications with the food industry and acknowledge the need to consult and engage. This is, in fact, the conclusion of a paper by Australian academics, but which also argues strongly that industry – incentivised to “oppose, delay, defer, or dilute” – should play no part in formulating public health policy. 

Back in the UK, the BMJ revelations have renewed calls for an end to the conflicts of interest between food industry and the government’s advisory committee on nutrition. Campaigners reject the argument coming from some quarters that removing SACN members with any links to industry would diminish the committee’s expertise, and that partnerships with industry help secure funding for important research. Since industry is already funding so much of the research in this area, and clearly willing to do so (back to capturing the science), the far more pertinent question is how this became the lethal cultural norm.

Jim Manson, editor, Natural Newsdesk