How do we reduce demand on over-stretched health services? Well, it might help to work towards a healthier society. Whilst it’s important to give health services enough resources to look after the sick, it’s not Medicine, not drugs, nor vaccines, nor “gene therapies” which have ever made the greatest contributions to population health. And it never will be.
As best I can see there are a number of issues to consider and all of them involve we human beings working together to create healthier societies. It’s what we can achieve when we work together that really impresses me. Sure, individual choices, personal behaviours and so on can result in valuable improvements for each of us in our own lives, but we don’t live in isolation. We are embedded in complex webs of environments and societies. If we don’t pay attention to those environments, our personal choices run the risk of being overwhelmed by the noxious factors outwith our individual control.
The first issue I explored was housing. After all, without adequate shelter, human beings perish. And with over-crowding, poor sanitation, inadequate supplies of clean water and power millions suffer from poor lives and are vulnerable to the ravages of acute infections, trauma and a growing number of chronic inflammatory conditions.
The second issue I’d like to explore is food.
Patients often asked me if I had a “diet sheet”. I didn’t. Maybe that was naive of me, but I don’t believe that one “diet” fits all. We are all different. Not only in our tastes, but in our tolerances, and even our needs. I think healthy diets can be as varied as human beings are. Yeah, sure, too much this, and too much that, is rarely healthy, but trying to single out a particular food or food group as “good” or “bad” always struck me as foolish. No single food is a miracle cure for anything, and no natural foodstuff is just downright bad.
I’ve always admired the work of Michael Pollan. Two things he has said are especially helpful. The first is “Eat food. Mainly plants. Not too much.” That seven word dietary advice seems very wise to me. Starting at the end, the “not too much” captures the need for both moderation and variety in a healthy diet. “Mainly plants” points to the fact that too much meat can be a problem. And “eat food”, although that sounds strange advice, actually captures one of the most important points. Why should we eat anything that isn’t food? Isn’t everything that we eat food?
Well, what he means by this is that the less processed a foodstuff is, the more likely it is to be nutritious. That connects well to the second point he makes, which is captured by asking yourself, “who made this food?” Because if it was made by human beings it’s more likely to be nutritious than if it was made by machines in a factory.
The more a foodstuff is processed, the more chemicals which are added to make it last longer, look a different colour, artificially change its flavour, the chances are, the less nutritious it’s likely to be.
This simple advice to “eat food” pushes us towards eating what is produced locally and seasonally. It’s one of the things I enjoy most about life here in the Charente since I moved here from Scotland. There is a local market every day except a Monday in Cognac, and within a short distance from here there are a large number of other interesting weekly markets. The markets regularly have stalls of locally produced, seasonal foods. The “locally” bit doesn’t mean only whatever is produced within the surrounding countryside. But it’s a sort of tendency. Yes, you can get what local farmers produce, but you can also get what’s grown in France, rather than what’s arrived from boats and planes over thousands of kilometres. And if you don’t see what you fancy from the local farms, or from France, then you can go a little further, and buy fresh produce from Spain or Portugal. Everything is labelled clearly. You can see how far it’s come.
I look forward every year to the Corsican clementines, the white and the green asparagus, the locally grown strawberries and raspberries, the various types of French apples and pears, the season of the walnuts, chestnuts, truffle. I swear that eating whatever is “in season” just tastes better. Is it healthier? I don’t know, but I want to eat food which is more than just “healthy food”, I want to eat food that is delicious.
The photo I’ve used at the start of this post is an example.
There is a network throughout southern France of Spanish orange growers and traders. They claim the time from tree to the stall in a local town car park is a matter of days. I have no way of verifying that but I can tell you I’ve never tasted orange juice quite this delicious.
Well, that’s me, and my personal circumstances. Yours will be different. But here’s my point.
The more we industrialise food production, the more we reduce its potential nutritious value, and the more we run the risk of non-food consumption of a mind-boggling list of man-made chemicals. This goes all the way back to the farming methods. Factory farming of cattle, pigs, chickens, and of plant crops, demands huge inputs of energy and chemicals, from antibiotics, to growth hormones, pesticides, fungicides, insecticides and so on. All these additives in the food chain aren’t food.
Even without considering the ethics of rearing animals in these conditions of mass overcrowding, one of the biggest problems is that these factory farms mainly feed other factories…..the ones which “process” the original plants and animals so much that you often can’t be sure what you are eating by the time it arrives on your plate. Is that beef, or horse? What part of the animal is used to make those nuggets? The label shows a list of substances you struggle to pronounce, and you sure don’t know what they are doing there, and whether or not they are at least not harmful, or, at best, good for you.
So can we apply these principles to food? The basis of all health? Good, nutritious, delicious food?
What if we prioritised, favoured, both personally, but also at the level of society through economic and political policies and controls, the following qualities –
- Less added chemicals – at all stages – from the farm to the shop
- Less processing and more transparency – so we can know what we are eating
- Less transporting – which will favour more local, more seasonal, fresher food
- More variety – every study I’ve ever read shows that populations which have more variety in their diets, often because they eat more seasonally, have longer, healthier lives.
The food economy of a society impacts the planet and its climate, the soil and the oceans, all forms of life, and, in particular, the health of whole populations.