Food and Public Policies
The promotion of healthy eating is the responsibility of diverse stakeholders and has multiple antecedents and consequences. At the global level, public food and nutrition policies are currently aimed at the prevention of obesity and other non-communicable diseases that are clearly linked to the quality of diet. Malnutrition may equally be the result of excesses or deficiencies in the nutrients consumed, and may lead to a number of diseases and conditions, such as diabetes, hypertension, heart attacks, strokes along with some types of cancer all of which are associated with increased morbidity, mortality and early-onset disability. According to the FAO, WFP, UNECE, UNICEF, WHO and WMO (2021), unhealthy diets account for approximately 86% of deaths and 77% of the disease burden in Europe and Central Asia. Hence the need for a thorough analysis of the degree of compliance with and implementation of a good quality diet and those factors that facilitate its adoption, such as public policy. Governments must establish clear guidelines both for consumers in their food shopping habits and for catering services throughout their value chain (purchase, supply, distribution, processing, sale and recycling) in order to develop nutritional criteria for the food that is served in public establishments and, by extension, in all contexts. There should be no reticence in encouraging the availability of the most suitable food types and in giving every facility to organizations that promote balanced diets. Meanwhile, the marketing of unhealthy foods should be actively restricted and additional measures should be adopted, such as tax disincentives on food manufacturers that use excessive amounts of harmful nutritional components in their products. The deterioration of health and the shortening of life expectancy resulting from poor nutrition constitutes a drain on public resources that no government can afford to ignore.
New lines of academic research are emerging concerned with the legal and ethical limits of public policy in this area. Pressing questions require clear responses, such as what is the responsibility of a company that manufactures products harmful to health? Should this responsibility be shared and, if so, how should it be apportioned? Certainly, responsibility must rest equally on the manufacturer as well as on regulatory or legislative bodies and must, at the least, implicate the transnational companies that promote and control global eating habits. Fifty percent of worldwide food production sales is in the hands of 50 corporations and this market share grows year on year with the largest manufacturers increasingly dominating production1 (Rosa Luxemburg Foundation, Friends of the Earth Germany (BUND), Oxfam Germany, Germanwatch, 2018).
The processes of industrialization driven by new lifestyle habits and consumption demands have contributed decisively to the eradication of hunger, but they have also favored an excess in the ingestion of calories and the promotion of associated diseases. Clear examples are the over-consumption of sugary drinks (Ma, 2015; Kearns et al., 2018), the use of trans fats (Cordner & Tamashiro, 2015; Cabezas-Zábala, Hernández-Torres & Vargas-Zárate, 2016) and the increased use of salt (Kotchen, Cowley Jr, & Frohlich, 2013; Wilck et al., 2017), all of which contradict the recommendations of the WHO (2021a). This situation highlights the need to 1) restrict sodium intake and ensure that salt for human consumption is iodized, 2) limit the consumption of free sugars, 3) prioritize the consumption of unsaturated fats over saturated fats, 4) stop using industrially processed trans fatty acids, 5) increase the consumption of whole grains, vegetables, fruits, legumes and nuts and 6) ensure the free availability of drinking water.
This excessive consumption is paralleled by the increasing use of all types of plastic containers for take-away food and individual drinks that is part of the business model of promoting individuality and consumerism at low cost (Ritchie & Roser, 2018; Waring, Harris & Mitchell, 2018; Luque 2019). As an example, the impact of bottled water on natural resources is 3,500 times greater than tap water (Villanueva, et al., 2021) and, in the U.S., 17 million barrels of oil are needed to produce the plastic to meet the annual demand for bottled water (Harvard, 2021) despite bottled water being 50 to 500 times more expensive than tap water (Madeblue, 2021). Regulation that favors the public interest and that binds the manufacturing sector must become the rule and not the exception in order to limit such irresponsible behavior that serves only the producers and distributors. It should be borne in mind that industrial giants at the global level, from food to tobacco and oil, have habitually meddled with scientific research in order to conceal the dangers of their products, cast doubt on otherwise clear evidence or delay the implementation of effective regulation. This has been facilitated by the collaboration of pseudoscientists, custom-made “academic journals” (some of which are considered high-impact), and the complicity of some supranational bodies, and has been reinforced by the channels of leverage at their service, such as lobbying and widespread corruption (Johns & Oppenheimer, 2018; Luque & Herrero-García, 2019). This exemplifies once again the lack of ethics and the existence of normative asymmetries that point to the existing reality of a sham globalizing idealism (Beck, 2008).
However, the implementation of public policies far removed from the influence of vested interests is possible. Denmark was the first country in the world to regulate the consumption of artificial trans fats, which are closely associated with the incidence of cardiovascular diseases (CVD). Before the trans-fat policy was implemented, CVD mortality rates in Denmark closely tracked those of a weighted average of other OECD countries (i.e., the synthetic control group). In the years before the policy came into force, the annual mean was 441.5 deaths per 100,000 people in Denmark and 442.7 in the synthetic control group. In the 3 years after the policy was implemented, mortality attributable to CVD decreased on average by about 14.2 deaths per 100,000 people per year in Denmark relative to the synthetic control group (Restrepo & Rieger, 2016). In Brazil, Law No. 11.947/2009, The National School Food Program, requires that 30 per cent of the budget be used to purchase food from family farms and that menus be prepared with fresh or minimally processed foodstuffs, all in accordance with the sustainability, seasonality and agricultural diversification of each region. Furthermore, produce is sourced from the same locality as the school whenever possible. In the Republic of Korea, so-called “Green Food Zones” have been established to promote child health by regulating the food available for purchase within 200 meters of schools (South Korea's Ministry of Food and Drug Safety, 2021). According to UNESCO Director-General, Audrey Azouley, “A school that is not health-promoting is no longer justifiable and acceptable. I call for all of us to affirm our commitment and role, to make every school a health-promoting school” (WHO, 2021b).