Saturday, 1 December 2018

Sweetening austerity

Last week, I took part in a wonderful symposium, organised by Elaine Swan (Sussex) and Maud Perrier (Bristol) on Foodworks: Gendered, Racialised and Classed Labours, and this felt like the perfect opportunity to try and work up an idea that I've been dancing around, but which I now think is going to lie at the heart of the book from the sugar project - the connection between austerity and the rush to sugar, or what I have called, the sweeting of austerity. This post gives a brief summary of the ideas I discussed in my paper, and which I hope will now provide the foundations for the book proposal that is languishing in my to-do folder...

One of the key questions I've been asking myself about the rush to sugar is 'why now?'. (There's a whole other question about 'why sugar?', which I'm also working on, but that's for another post). As this chart clearly shows, there is a clear rise in sugar reporting in the early part of the 2010's after a long period of very modest and steady reporting, and I've been struggling to explain it, beyond a rather vague allusion to the need for the 'war on obesity' to continually revive itself:

But I recently read Tracey Jensen's fabulous book on parent-blaming in the context of austerity, Parenting the Crisis, and was struck by the resonance of her analysis with the ways in which the 'problem' of sugar (and those who are deemed to over-consume it) is framed and represented. So I returned to my chart, and started to take seriously the timing of the rise of sugar in the news, and in particular, its coincidence with start of the 2010 Conservative-Liberal Democratic coalition government and their subsequent enactment of aggressive austerity measures, including the 2012 Welfare Reform Act. These measures shrunk the welfare state, enacted punitive sanctions against those unable to conform to the proliferating conditionality's of the benefits system and created conditions of profound precarity and poverty in some of the most disadvantaged sections of society. this occurred alongside, and was facilitated by, a hardening of attitudes towards those dependent on the welfare system, including health care, sedimenting a binary between the feckless 'scroungers' who are seen as irresponsibly over-consuming public resources and the deserving 'strivers' who work hard and take responsibility for themselves and dependent others, thereby limiting their claims on public services. From this starting point, I want to make the case that austerity provides the context through which the attack on sugar has gained purchase, particularly via discourses of irresponsible overconsumption (of sugar, of health services); and conversely, the attack on sugar shores of the figure of the abject other whose presumed fecklessness is central to securing public consent for the unequal cruelties of austerity (as Imogen Tyler explains much more eloquently in her book Revolting Subjects). As such, I'm not suggesting that austerity caused the attack on sugar, but rather, that it made it possible. 

In my symposium paper, I focused on two aspects of these synergies between austerity and sugar. Firstly, I looked at the way that 'the poor' are repeatedly described as much more likely to consume higher levels of sugar, to be fat and to experience chronic (and expensive) health problems, and therefore, that they should be the prime targets for anti-sugar interventions which are presumed to provide greater health gains (and financial savings) among those communities. This targeting of the poor as simultaneously the problem and the solution (as with all austerity measures) dislocates those disadvantaged individuals, households and communities from the wider social context in which their poverty is realised and sustained. In this way, it is possible for Boris Johnson in 2015, while still mayor of London, to describe a sugar tax as "a matter of social justice" since "overwhelmingly the people who will be most affected by an obesity problem will be those on the lowest incomes?" - a claim which blatantly obscures the austerity measures in which Johnson himself is heavily complicit. In these claims to social justice, the poor are held accountable for their own ill health and suffering, both in terms of their presumed imperviousness to dietary and health advice (thereby placing them in the frame for the erosion of the NHS), and in their presumed dietary incontinence. As discussed in a previous post about freakshakes, the working classes cannot be trusted with treats and don't know when to stop. These discourses and practices of objectification and blame lie at the heart of the austerity project and lend themselves seamlessly to the attack on sugar. 

The second aspect I addressed in my paper was the work that the attack on sugar generates, particularly for women, who, as the primary providers of reproductive and domestic labour, are held responsible for securing a 'healthy' diet for those in their care, including male partners. The newspaper are full of what I have called 'mortified mother' stories, which borrow the make-over format beloved of reality TV to expose a family's 'real' sugar consumption through expert evaluation, and then re-educate and reform the shame-filled mother. She learns to read labels to avoid 'hidden' sugars, calculate grams of sugar, make pasta sauces from scratch, cook porridge for breakfast rather than handing out cereal bars and generally lower her family's sugar consumption without inconveniencing them. The division of labour in the household is never addressed, and the gendered work of being what Change4Life call "sugar smart", like the gendered impacts of austerity more generally, are rendered invisible. 

These economies rely on an endless series of micro reduction in sugar that are parsed by the teaspoon, as illustrated by these suggestions from Action on Sugar during Sugar Awareness Week:

These normative sugar economies and their invisible footwork align comfortably with the romance of austerity, where thrift is celebrated in joyful contrast to the irresponsible over-consumption of socially abjected individuals (Tracey Jensen is eloquent on this romancing of austerity in her book). And just as the bedroom tax or a focus on benefit fraud make very minor contributions to the overall benefits bill but are symbolically laden and discursively potent interventions for sustaining and justifying health and social inequalities, so is the demand to save a teaspoon here and a teaspoon there. In this way, we need to understand the attack on sugar as never simply about an objectively knowable threat to health, but also a vector for social anxieties around deserving and undeserving citizenship, and warranted and unwarranted consumption (of food, of public resources). 

This is what I mean by the sweetening of austerity, and hopefully, this will be the core of a book which is not going to happen quickly, but is one step closer to being realised. 

Thursday, 15 November 2018

Freakshakes panic

Our friends at Action on Sugar are at it again, this time for Sugar Awareness Week, which is taking dining out as its theme / target for this year. They have returned to their time-honoured formula of reading nutritional labels in order to uncover 'shocking' amounts of sugar in sugary foods in order to bolster a demand for nutritional labelling. This week, they have turned their attention to the 'freakshake' -a combination of milkshakes, desserts, sweets and cakes, brought together to form an overflowing, heaped confection that is purposefully and unavoidably excessive.

The freakshake was an innovation of the Pattisev Civic Cafe in Canberra in 2015, triggering a trend that blossomed and quickly ran out of steam, but which then travelled internationally. They are designed to be excessive, incorporating nutella, sweet sauces, cream, cookies, candy and cakes in a way designed to shock and delight. In the UK, freakshakes can be purchased at outlets like the Toby Carvery and Harvester

In breathess horror, the Action on Sugar press release tells us that the Toby Carvery Unicorn Freakshake contains 1280 calories and that some shakes deliver up to 39 teaspoons of sugar; they called for a ban on similar products over 300 calories, and argued on Twitter that when consumed on a daily basis, they were the cause of obesity and tooth decay in children:

The focus on tooth decay is a relatively new departure for the organisation, whose primary focus has always been obesity. Concerns about tooth decay serve as a useful distraction here from the fat-hatred that underpins much of their public-facing material, and in practice serves as code for contempt for the fat body and its presumed (over-)consumption, as in their dental-themed poster: 

The media ate the story up, revelling in the obvious excess of the shakes and milking the controversial proposal to ban them for all it was worth. 

But we should pause for thought. Firstly, the idea that these are being consumed by children, or anyone, on a daily basis is fanciful. At over £5 per shake, it is ludicrous to suggest that these are part of people's everyday diets. Instead, it is far more likely that they are an occasional treat, as well as a social event - a dessert to share and a piece of excess to photograph, enjoy and bond over. Secondly, the 'shock' expressed by Action on Sugar at the sugar content of these shakes is at best naive, and at worst, disingenuous. Of course they have a lot of sugar in them (and much else besides) - the name 'freakshakes' is the giveaway here. Thirdly, they have fallen into the familiar trap of focusing on nutritional content to the exclusion of context. The survey tells us nothing about how these shakes are consumed, and by whom, in what quantities and at what frequency. And this points to the fourth, and most damning, problem with Action on Sugar's latest 'hidden sugar shock' campaign - it's profoundly classed nature. By focusing on outlets like Toby Carvery and Harvester, they are signalling classed forms of consumption that suggest that only some can be trusted to consume treats moderately. No-one is calling on Jamie Oliver to ban his 600+ calorie dessert, The Ambassador (49g / 12 teaspoons of sugar), but 'highstreet' outlets - which is increasingly code for 'working class' - are directly in the firing line, presumably because their customers are not to be trusted in the face of the 'freakshake', which they are assumed to consume repeatedly and in ignorance. And this leads to the fifth problem - the assumption that the answer to the 'problem' of the freakshake, as with all processed foods, is clear labelling. The call for nutritional labelling is premised on the conviction that if only people knew what was in their food they would make better choices, but do Action on Sugar really believe that those purchasing a 'freakshake' are unaware that it has a high sugar / fat content? Are they not aware that the shared pleasures of excess are probably the precise point of purchasing it in the first place? 

Sugar Awareness Week is a combination of shock tactics, calls for labelling that assume consumer ignorance, the dislocation food from the context of consumption, and miserly calls for small sugar economies: 

These are a disturbing echo of the demands that those living on ever-diminishing benefits should / could survive cheaply on less, effectively blaming them for their own hunger and malnourishment. The hand-wringing focus on the purposeful and celebratory excess of the freakshake obscures classist assumptions about the chaotic consumption and nutritional ignorance of the poor (and sick) and, once again, fails to engage with the social life of food and foodwork in the interests of political expediency and an easily packaged, attention-grabbing message. 

I do not believe that Action on Sugar are actually shocked by the amount of sugar in a freakshake (and if they are, then they immediately relinquish the right to comment on nutrition), but I do believe that they are actively and cynically mobilising the rhetorics of 'shock' in order to communicate a message dangerously dislocated from the social world in which food - including freakshakes - is consumed and made meaningful. And for this reason, we should be very sceptical. 

Monday, 10 September 2018

A week of liquid lunches: a Huel experiment...

There's been a recent proliferation of what I am calling "deliverable nutrition" - that is, products that offer meals actively coded as nutritious, but which are quick and convenient to prepare. It's a direct response to concerns about the heavily processed foods in which sugar is commonly implicated, and which are widely understood as nutritionally poor and health damaging. I'm including products such as meal kits (e.g. Gousto, HelloFresh), chilled, freezable, freshly made 'ready meals' (e.g. Allplants) and meal replacement shakes (e.g. Huel). These products and services are characterised not only by claims to being nutritionally positive, but also convenient, environmentally responsible, low-waste and economical, while providing 'real food', which is 'fast' but not 'junk'. They differ in cost, the preparatory work demanded of the consumer and in what constitutes a 'meal', both materially and as an event. Products are increasingly being tailored to specific dietary preferences, such as gluten free, vegan and low carb, and customers are invited to subscribe in order to minimise costs and to secure brand loyalty. They are not marketed directly as weight loss products, although the shadow of obesity is ever present.

As I start to think about these, I decided that I should try some of them out before working on them further. I'm slightly limited by the fact that I am a vegan, which not all services cater to comprehensively, but I decided to start out with the one that I was most sceptical about, since it is the one most obviously distanced from recognisable food: Huel. According to the website, Huel (a contraction of Human Fuel) is "a nutritionally complete powdered food that contains all the proteins, carbs and fats you need, plus at least 100% of the European Union's 'Daily Recommended Amounts' of all 26 essential vitamins and minerals". It is, according to the website, "the future of food" - an answer to the problems of poor nutrition, food waste and obesity that are seen as characterising contemporary society. The blurb on the website looks back nostalgically to a pre-agricultural revolution past where hunter-gatherers ate from nutritional necessity and were in constant motion - a life that eventually gave way to the constant availability of processed foods and inactivity. In line with every food revolution / anti-obesity intervention, they demand that "Something must be done" about the current parlous state of population health and (over-)consumption, and Huel presents itself as one answer. It is entirely vegan, and is made from a blend of oats, pea protein, flaxseed, brown rice protein, medium chain triglycerides (MCTs) from coconut and sunflower oil, a bespoke vitamin and mineral blend and a sweetener. It comes in five flavours (vanilla, berry, original, coffee and unflavoured / unsweetened), plus there is a range of powdered 'flavour boosts' including mint chocolate, banana, pineapple and coconut, chocolate and more. At its most economical (by buying on subscription in bulk), it comes in at £1.33 per meal; the starter pack of two bags of Huel powder plus a branded T-shirt, shaker and plastic scoops works out at £1.45 per meal (@28 meals for the two bags).

Huel was an obvious choice for me because it is vegan, and I ordered a starter pack, selecting one original (vanilla) flavoured bag and, knowing that I'm not keen on heavily sweetened shakes, one unsweetened / unflavoured.

The design is minimalist, in line with its mission to simplify good nutrition, and the product has a shelf life of a year in its easily resealable bags. The website recommends consuming 2 Huel meals a day, focusing on breakfast and lunch, given that these are the meals most people will be more likely to eat on the go, followed by a balanced third meal. But they emphasise flexibility here - that some will just want one Huel meal a day; that others will need more than three meals (e.g. people who are physically active or trying to bulk up); or that some will want to have an additional small snack meal (one scoop, rather than the prescribed three for a full meal), which we are told equates calorifically to a bag of crisps. The basic method of preparation is three scoops of Huel mixed with water and then shaken vigorously to blend. You can add in flavour boosters, and they also suggest adding some ice-cubes. Additionally, they suggest that the powder can be used like flour for baking, and there is also a range of branded bars and granola, which I didn't try. 

For my first Huel meal, I tried 3 scoops of original vanilla with water and shook it up in the branded shaker, but this was not a success for me - it was too grainy, and the oaty taste was unpalatable. I went back to the website and social media pages and found lots of suggestions from fellow "Huelers" about how to customise the product to taste, so I tried again. This time, I added in a frozen banana, some frozen berries and almond milk instead of water, and whizzed it up in a high speed blender. Much better. This was much creamier with a livelier taste, although the additions would add to the calorie counts (if you care about such things), and to the cost per meal. (I was frustrated at first that they don't do taster packs and make you buy two whole bags from the get go, but I started to see why - you have to experiment to find what works. Otherwise, I would definitely have stopped after that first try). I decided to go with the recommended plan of 2 Huel meals a day for my trial week, and began to experiment with the taster box of flavour boosters that I had also purchased with my starter pack, always blended with a frozen banana and almond milk as a base, and depending on the flavour, sometimes other frozen fruits. My favourite by far was the mint chocolate, which is delicious; this was always my favourite ice-cream flavour and one of my biggest losses since becoming vegan, so this was a lovely surprise. I had an unfortunate encounter with the mocha flavour, which is very tasty, but contains caffeine. If I'd thought about it, I should have known, but since the package only referred to 'flavourings', I casually assumed that it was caffeine free; I don't consume any caffeine normally, so was treated to an afternoon of a racing heart and headaches. My mistake, although it could probably do with being stated directly on the package. 

I never managed to get on with it just shaken up with water or almond milk, which limits its portability and convenience and requires some planning ahead for consuming out and about, but with a frozen banana, some flavouring and a blender, I found it easy and palatable. And it is surprisingly filling, keeping blood sugar levels very stable and eliminating the between-meal munchies. However, because of injury, beyond a bit of running and Pilates, I'm not doing anything like my usual training and my appetite is pretty low, so I would probably have needed more Huel meals, or regular food, otherwise. There are lots of warnings online about potential digestive disruptions after switching to Huel - depending on how high in fibre your previous diet was, its high fibre content can be a bit of a shock to the system - but as someone who eats a primarily whole foods, plant-based diet, this wasn't an issue for me. I felt well nourished and energised, and while I am slightly sceptical about claims to 'complete nutrition' that can't really take into account individual needs and which presume a certainty of nutritional knowledge that isn't really supported by the history and present of nutritional science, I really felt like I was 'eating' well and getting what I needed to go about my daily business. Nutritionally speaking, I'd feel fairly confident about consuming this on a longer term basis. The website states very clearly that this is not a weight loss product, but many "Huelers" are clearly using it as such, and the forums and social media are full of triumphant reports of pounds lost (with the occasional person using it to bulk up). As a point of principle, I do not weigh myself and so don't have any idea whether it affected my weight, and a single week wouldn't tell us anything useful on that front anyway. 

So what is my verdict? It is highly palatable (in my case, when blended with frozen fruit and flavour boosters), nutritionally effective and very time-efficient. It is very effective in producing satiety, and if you're in a rush, it's a much better solution than scouring the sandwich section of the supermarket for something vegan that will probably only fill you up for a couple of hours. It would also be a good back-up for long train and car journeys, when it can be difficult to find any decent vegan food on the go. It's reasonably economical, although these things are all relative, and it would still be well out of reach for the many people currently living on devastatingly curtailed benefits and low wages in this country. And it has the benefits of considerable adaptability of taste and texture, which fends off the boredom (to some extent) that accompanies many meal replacement products. So in many ways, it gets a thumbs up from me. 

But...and it's a big but... while I think it's a good product, I just couldn't get fully on board with the concept and I really started to miss actual food that you have to chew. There's something quite infantile about consuming shakes, especially given that they're mostly some version of sweet. I found the shaker too alienating and had each meal out of a glass instead, which helped; I even tried making it up very thick so that I had to eat it with a spoon like melting ice-cream (a mint chocolate winner). But while it meets nutritional needs, it strips away all the other meanings and functions of food, and the decisions that come with it. Of course, this is exactly the appeal of meal replacement shakes for many, and especially those for whom the management of food is an exhausting emotional and / or practical struggle - it takes food and food decisions off the table. But I want my meals to be more than fuel, and I missed the 'foodness' of food too much for it to be a workable long-term solution for me. I did my trial while my partner was away for the week, but I couldn't imagine us sitting down to a couple of glasses of Huel together, and I found my half-empty fridge depressing; I missed the process of rummaging around and pulling out ingredients to prepare my meals (although I accept that this too is a privilege of time and resources), or opening up my lunchbox at work to a heap of delicious leftovers from the previous night's dinner. And I really missed savoury food; by the time I got to my evening meal, I was desperate for foods of different textures and tastes. If powdered nutrition really is the future of food, I worry about the direction we're heading; perhaps instead we should be talking about the financial and time pressures of everyday life and work that make sitting down to a freshly prepared meal impossible and that make shaking up a liquid lunch a plausible long-term solution. 

Having said that, I will be keeping Huel at the ready in my cupboard, especially for office days, when I often have to leave the house too early to be able to stomach breakfast and end up eating toast at the office, which leaves me peckish again by 10.30. I love that it's vegan, and think that a lot of time and energy has gone into making an adaptable, tasty product; they also have excellent customer service and easy and prompt delivery. It was a fun experiment, but I have to say that I'm glad it's over; it turns  out that I just like food too much to be a dedicated "Hueler". 

More deliverable nutrition experiments to follow. 

Saturday, 11 August 2018

Beware the dangerous Battenberg...

Hot on the heels of their blueberry muffin hidden sugar shock survey back in March of this year, Action on Sugar are back with a new survey, this time with the added gloss of scientific authority through publication in the open access journal, BMJ Open. The study is a survey conducted in 2016 of the sugar content of 381 cakes and 481 biscuits available in 9 main UK supermarkets, and gathered the sugar and energy content from packaging and labelling with the aim of exploring variations across products. The findings, perhaps not surprisingly, were that cakes and biscuits contain quite a lot of sugar, with 97% of cakes and 74% warranting a 'red' traffic light label for sugar content. But as with the blueberry muffin story, the aim is not really to show that cakes and biscuits are sugary, but to highlight the variation in sugar content between products - a finding which is taken as illustrating that reductions in sugar and energy content are possible but that manufacturers are dragging their feet in doing this.

And because every food story needs an enemy, the paper holds up Battenberg cake as containing the highest average amounts of sugar, while the blueberry muffin is somewhat redeemed from its previous shaming by having the lowest average sugar content among the cakes. The media jumped on the Battenberg story, and the Sunday Times published this graphic (credited to Queen Mary University, which is the institutional home of the four authors):

The graphic uses the familiar measure of the teaspoon to quantify the sugar, but uses 100g portions, even though serving data is also included in the study. In the case of the Battenberg for example, a 50g serving would be up to 7.5 teaspoons, which still equates to a full adult allowance, but is much less headline-grabbing than 15 teaspoons. While the Sunday Times was busy throwing up its hands up in horror at the public health threat posed by Battenberg cake, the Guardian stepped in to protect readers from the "dangerously sugary" real thing with a low sugar alternative that could be made at home. This included making low sugar marzipan using medjool dates and strawberry coulis rather than using jam. While there is certainly much fun to be had in home-baking, it seemed like an awful lot of soulless trouble to go to to shave off a teaspoon or two of sugar from something that's meant to be, well....sugary. 

The BMJ Open study describes its key limitation as having to rely on nutritional information provided by manufacturers. This is not only a not-so-subtle suggestion that manufacturers can't be trusted, but also, it completely overlooks the real problems with this study, which lie in its inability to see cake (and biscuits) as anything other than a collection of nutrients. Within this nutritionist frame, all cakes are the same, or at least, all Battenbergs or all brownies are the same. Indeed, the conclusion that reformulation is possible is founded on the conviction that different brands of the same type of cake are fundamentally the same thing, with some just more responsibly formulated than others. But we all know that this isn't the case - not all chocolate cakes, or all Battenberg cakes, are the same, with taste and texture depending on how it is constituted and manufactured; and purchasing is governed by cost, but also by preference or occasion - someone might buy a rich, expensive cake for a special occasion, but something less expensive as a more mundane treat. When we do this, we know that those two products are not the same and balance the different factors accordingly; the failure of the authors to see this shows a spectacular dislocation from the lived experience of food. 

And following on from this, the study completely overlooks the affective dimensions of cake. When I saw the Battenberg story, and all of the media images of this yellow and pink confection, I flashed immediately back to my Nana's dining room table at tea time in the 1970's. Cake has meanings far beyond its specific nutrients; in this case, it was a dramatic taste-memory full of grandparental love, delicious treats and happy days. I know that this attaching of emotions to sugary foods is exactly the kind of thing that anti-sugar campaigns object to, and we are constantly being urged to find new ways to share birthdays, celebrate successes or find consolation, but the reduction of food to an assemblage of nutrients is to completely ignore the fact that (all) food is irretrievably social and the meanings it bears can never be contained in the 'nutritional information' label. I find it hard to take dietary advice seriously when it comes from a position of such utter dislocation from food and eating. 

I don't eat shop-bought cakes, not because I'm horrified by their sugar content, but because I'm a vegan, which excludes pretty much all supermarket cakes and biscuits; ultimately, I think that the killing and exploitation of animals to make those products is far more disturbing than their sugar content. (This is a blog for another day, since the derogation of veganism is a staple of the low-carb, high-fat diets in which many prominent anti-sugar activists are heavily invested). But regardless of whether I eat those products or not, I am convinced that it is necessary to push back against this kind of reductive categorisation of (particular) foods and ingredients as a threat to health. If the authors of the report are right, and those particular products are to blame for both obesity and the health problems commonly associated with it in ways that constitute an urgent public health crisis, then it is hard to see how determinedly reading the labels of over 800 products that people already know to be sugary can intervene meaningfully in that. If they're wrong, then the splashing of 'hidden sugar shock' stories like this across the media constitutes a troubling distraction from broader questions about food quality, accessibility and affordability in contemporary society, and disregards the profound social significance of food, including cakes and biscuits, and the ways in which it becomes meaningful to people in complex and unpredictable ways. 

So hands off the Battenberg. Nana knew best. 

Tuesday, 5 June 2018

Taxing Sugar

On April 6thof this year, the Soft Drinks Industry Levy – more colloquially known as the ‘sugar tax’ – came into effect. Framed as part of attempts to tackle child obesity, the levy added 18p per litre for drinks containing 5-8g of sugar per 100ml, and 24p per litre for drinks containing more than 8g of sugar per 100ml. The levy was declared a success even at its outset, with a Treasury press release noting that since the announcement of the tax in the March 2016 budget, over 50% of manufacturers had already reduced the sugar content of their drinks in order to pre-empt the levy. The press release promised that the £240 million expected to be raised from the levy would be used to fund school sports programmes and breakfast clubs. As it came into effect, celebrity chef and anti-sugar activist, Jamie Oliver, tweeted an image of sugar cubes arrayed in front of bottles of soft drinks to show their added sugar content, along with the link to his website, where he applauded the move, describing sugary drinks as “the single largest source of sugar and empty calories in our children’s diets – action is essential”.

But amidst the self-congratulatory praise for the sugar tax from its advocates as striking a brave blow for child health in the face of industry opposition, the foundational assumptions upon which the sugar tax is built remain highly problematic, particularly in its loose relation to evidence and the dislocation of the desire for ‘action’ from the social and material inequalities which frame the consumption of sugar. In this blog post, I explore some of the debates and assumptions around the sugar tax and how these frame the ‘problem’ of sugar. 

Responses to the sugar tax ranged from cries of ‘nanny state’ interference to celebratory demands to extend the tax beyond sugary drinks to include all high sugar snack foods. But they find common ground in the construction of obesity as a problem, with the fat body figuring variously as a disease, as the cause of other diseases, as the visible proxy for (preventable) ill-health, and most importantly, as a problem about which, in Oliver’s terms, ‘action is essential’ – a compulsion to act which loosens the reliance on evidence in favour of immediate action. For example, the case of Mexico is commonly cited as evidence of the effectiveness of taxation. Following the introduction of a tax on sugary drinks in 2014, sales fell by approximately 12% by the end of 2014 (and up to 17% among the poorest communities), fuelling demands for similar measures elsewhere. However, the health effects of this reduction in sales remain entirely theoretical, and there is currently no evidence of the desired health benefits for which falling drinks sales are mobilised as a proxy. Closer to home, Jamie Oliver’s 2015 decision to add a 10p levy to the added-sugar drinks in his “Italian” chain of restaurants, resulting in a 9.3% decrease in sales over 6 months, was hailed as auguring well for the sugar tax, with reduced consumption functioning as a proxy for health biomarkers and as predictive of the effects of a tax at the national level. However, this fails to take into account the class profile of his customers, who will already have been strongly attuned to the moral hazards of sugary drink consumption and Oliver’s vocal role as an anti-sugar advocate. Furthermore, it is disingenuous to align the decision to drink, or not drink, Oliver’s ‘fairtrade and organic’ Karma Cola (£3.00) on a restaurant night out with the real targets of the sugar tax – those of lower socio-economic status whose consumption is prefigured as excessive, ill-informed and most in need of intervention. 

The construction of sugar as a ‘problem’ that affects us all, and of interventions aimed at middle class restaurant patrons as offering meaningful lessons across populations, entrenches and obscures social inequalities in ways that mitigate directly against structural change in favour of the coercive ‘nudging’ of food individualised food choices. For example, the channelling of the revenue from the tax into school sports smoothes quietly over the devastation of (state) school sports facilities by consecutive governments, while simultaneously shoring up the normative link between sport and the ‘war on obesity’. This forces those children already targeted because of their size to endure the shame of participating in a class whose specific goal is to eliminate bodies like theirs. 

Plans to use revenue to provide food for hungry children also conceal disturbing truths about life in contemporary Britain through their normalisation of poverty and deprivation. For example, in January this year, a group of Conservative MPs including Jacob Rees-Mogg, Nicky Morgan and Nicholas Soames teamed up with ex-Labour front-bencher, Frank Field to call for revenue from the sugar tax to be used to address ‘holiday hunger’ among children with no access to free school meals during school holidays. It’s hard to object to hungry children being fed, but this philanthropic largesse leaves unaddressed the reasons why such a thing as ‘holiday hunger’ even exists in the UK today. Furthermore, it obscures the many other forms of suffering and hardship that a family experiencing profound food poverty must be negotiating, as well as the role of austerity measures such as benefit cuts and sanctions in creating and exacerbating those hardships – government policies supported by these same Conservative politicians (see for example, Rees-Mogg’s voting record).

Time will tell what effects – both desired and collateral – the sugar tax will have, but the aggressive pursuit of a single-nutrient solution to complex health and social problems should give us all pause for thought – not only in terms of who will bear the financial burdens of those interventions, but also what assumptions about individual responsibility, bodies and health underpin them. Just as Jamie Oliver’s campaign about sugary drinks isn’t really aimed at the consumers of his Karma Cola (or indeed his Epic Tiramisu dessert (£6.50, 40g of sugar)), the sugar tax targets the bodies and consumption habits of derogated Others, locking them into a narrative of exercise and education deficit to the exclusion of the broader social inequalities which they themselves might choose to prioritise as central to their own wellbeing. 

Sunday, 13 May 2018

The Daily Mile

There's been a lot of coverage in the news recently of The Daily Mile - a scheme for primary school children started by Elaine Wyllie, a head teacher in Stirling, Scotland in February 2012. The premise is very simple: at some point during the school day, all of the children go outside for 15 minutes of running around a pre-marked course (e.g. laps of the playground), aiming to jog or run a mile. The website claims that after 4 weeks, most children are able to run the full distance, and there are anecdotal reports of improvements in behaviour, concentration and sleep. In many ways, it sounds fun to be able to take a quick break between classes to blow off steam and stretch your legs; as for all of us, long periods of sitting are uncomfortable and stifling and it's hard to argue with introducing a short movement break into the children's day.

But there's a more disturbing side to the scheme that is going missing in the enthusiastic reporting: the direct linking of the Daily Mile with anti-obesity agendas. The stated aim of the scheme is "to improve the physical, social and mental health and well-being of our children - regardless of age, ability or personal circumstances", but it is obesity that is singled out as the crisis that needs to be addressed; the programme's letter to teachers, for example, states that "UK children are now the most overweight in Europe, and activity levels are worryingly low". The other anticipated benefits figure as collateral to the core aim, which Elaine Wyllie articulates as, "to help tackle our growing childhood obesity and physical activity crisis". This anti-obesity focus is demonstrated in the recent publication of research measuring the effects of the Daily Mile, in a BMC Medicine paper entitled: "The Daily Mile make primary children more active, less sedentary and improves their body composition: a quasi-experimental pilot study".  Using data from pedometers, BMI, skin fold tests and a shuttle run exercise, the study concluded that the results show a relative decrease of 18.2 mins / day in sedentary time; a relative increase of 9.1 mins / day in Moderate-Vigorous Intensity Physical Activity (MVPA); an increase in 39.1 metres in the shuttle run test; and a decrease of 1.4mm in the skin fold test. It hardly seem surprising that the introduction of an additional daily physical activity both increased activity rates and lessened sedentary time broadly in line with the time allocated to the activity; nor is it particularly surprising that children practising running get better at a test that measures running ability - a set of findings that seem relatively benign (although the definition of 'fitness' based on how far and fast you can run is very narrow).

But the skin fold test (which was conducted alongside height-weight measures) is more disturbing, given the assumption that a decrease in skin folds equates to 'improved' body composition - a non-too-subtle coding for the familiar coding of body fat as problematic - which in turn functions as a proxy for 'health'. There is no information on the Daily Mile website about how the scheme is pitched to the children, but those taking part in this study can have been under no illusions that a primary goal of the Daily Mile scheme was to get rid of undesirable fat through athletic performance as they were weighed and measured. The website also reveals the neoliberal discourses of personal responsibility into which the children are being inculcated through the scheme. The website's section on Health and Wellbeing, for example, argues that "children become more aware of their health and the need to take responsibility for it"; and the section on introducing the scheme into early learning and childcare settings describes it as "the opportunity to develop their 'physical literacy' and improve body composition for the rest of their lives". It's never too early to learn that the fat body can never be a 'good' body, and that we are individually responsible for our bodily condition. The aim that the scheme is for all children "regardless of age, ability or personal circumstance" is admirably inclusive, but at the same time flattens out the social factors that constitute health outcomes beyond the reach of 'individual responsibility'.

I had other questions. If one of the goals is to inculcate exercise habits that they will carry forward into their adult lives, is making them run outside whatever the weather really the best plan? And how, for example, is the experience of the Daily Mile gendered? In particular, girls often have to wear skirts that will cling to / wrap around legs restricting movement; they might also be wearing tights, the crotch of which every girl and woman knows will slide down her legs as soon as she moves around; and girls' shoes are notoriously flimsy and unsupportive compared to boys', as we can see in this promotional shot from the Daily Mile website:

And this leads me to my final question: does it have to be running? I can see that the singular focus on running is central to the scheme's commitment to making the intervention as simple, practical and unobtrusive into the school day as possible, but it also ties one particular mode of exercise (and one easily coded as 'healthy') to positive outcomes in ways that exclude others and cement the normative link between exercise and anti-obesity. What results would we see if children enjoyed a 15 minute break to sing songs, dance, go outside to see how many different birds or insects they can spot, or learn to juggle....? I suspect that busy teachers everywhere are now rolling their eyes at the prospect of such potentially complicated interventions into their already over-stuffed days, and they're right of course (although this is more an argument for changing the appalling working conditions of teachers in this country than one for sticking with running for simplicity's sake). But it is important to separate out what might be the benefits of a break from studying, and what is specific to running. And following on from that, what about those children for whom this is a nightmare? The website highlights the enthusiasm with which the scheme has been greeted by children, and I don't doubt that for many, it is joyful and invigorating, but what about those children whose bodies are most obviously the targets of this intervention (and who are already identified by other children as such)? Or those who just don't like to run, or can't' run?

I suspect that all of this makes me seem like a bit of a grouch. But the tethering of this potentially fun and positive activity for kids to the forceful prejudices of anti-obesity casts a dark shadow over its possibilities. What if we were to encourage playful exercise and activity without ever mentioning body size (or 'composition') or using it as code for 'health'? What if all children's bodies were already good enough and not subject to demands for 'improvement' in order to be counted as good citizens? The clinging of the scheme to anti-obesity goals makes it a terrible opportunity lost to think about bodies differently.

As the Daily Mile story circulated online and through social media, a few people posted on Twitter that it would be great to introduce this into our workplaces, and all I could think was that collective running in unsuitable clothing at my place of work in order to 'improve my body composition' was a vision of hell. Children are not adults and their school lives are very different to adult work lives, but I did find myself wondering how many feel the same way and what long term effects this might have. What memories and practices will those children whose bodies don't fit the narrative of self-mastery and 'improvement' carry into their adulthood? This seems like a much more pressing question than how many millimetres of fat they have lost.

Friday, 11 May 2018

Poverty and obesity

The Conversation recently published a piece by Martin Cohen, visiting research fellow in Philosophy at the University of Hertfordshire, entitled: It's poverty, not individual choice, that is driving extraordinary obesity levels. The article is headed with the familiar visual trope of fat stomach, ready to burst its shirt buttons - a lazy, fat-phobic suggestion (albeit probably picked by editors rather than the author himself) of the barely contained threat obesity is perceived to pose, and a reminder that sites of fat accumulation offer a direct means through which flaws and failings of fat bodies can be known.

Contra recent high profile campaigns by celebrity chefs like Jamie Oliver and Hugh Fearnley Whittingstall, Cohen argues that "finger wagging at sugary treats" doesn't even come close to addressing the 'problem' of obesity, which he argues is "a product of social inequality and requires a collective response". In doing so, he rejects the prevailing focus on individual choice and responsibility, drawing instead an analogy with nineteenth century public sanitation programmes to tackle typhoid and cholera. He doubles down on this analogy in his concluding sentence that "we need to collectively tackle the places where obesity germs breed - in stressed communities characterised by insecure and erratic employment, inadequate education, stress, depression and a lack of social cohesion". Although I doubt that Cohen intends us to think literally of 'obesity germs', the phrase is unfortunate, gesturing towards the rhetorics of 'epidemics' and contagion in ways which feed the already overwhelming stigma and fear that fatness ignites. This feeding of fear is the overall thrust of the piece - that the "obesity epidemic" needs more attention and more intervention, rather than less, and particularly in those areas, and in relation to those people, where poverty and obesity have coalesced.

In my previous posts, I have repeatedly reiterated my frustrations at the ways in which the attack on sugar, and by extension, on obesity, overlooks the social, economic and environmental contexts within which sugar is consumed and within which demands to cut back on sugar are made. However, I am categorically not arguing, as Cohen does, that we need to take social inequalities into account in order to effectively tackle obesity. The proper response to the correlation between poverty and obesity is not to ask "what social or collective interventions would be required to stop poor people being fat?", but rather, "what can we do to stop socially disadvantaged people being socially disadvantaged?" The measure of success for interventions driven by this second question wouldn't be something as facile as how fewer litres of pop were sold in local shops, or how many people lost weight, but instead would focus on access to education, respectful health care, employment, safe living environments and food security as social goods in their own right. The linking of poverty alleviation with anti-obesity campaigns and interventions elevates obesity as the over-determining problem, and at the same time constructs a frame whereby fat bodies are always bodies-out-of-place; the eradication of fat bodies is the only possible measure of success for anti-obesity campaigns, whether focused on sugary treats or social inequality. As such, they will always be campaigns of social exclusion, rather than inclusion.