How to spend a fortune on health and achieve nothing (aka the Budget Edition)

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The budget contained a blizzard of announcements on health. And most of them are focused on preventing chronic disease. But the reality is that they will have approximately the same effect on chronic disease (and cost twice as much) as the home insulation program – nada, nil, nothing and nix.

Chronic disease is a priority because (as the budget papers point out) the big three (heart disease, diabetes and cancers) ”account for 70 per cent of health care expenditure … [and] 50 per cent of GP consultations.” And these costs are projected to blow out to (really) unsustainable levels in the next two decades.

And the reason for all this chronic disease trouble? Well, that’s easy, we’re all ‘too fat’. According to the papers, “[the number of fat people] has significantly increased over the last 25 years [with] 68 per cent of adult men 55 per cent of adult women [now being] overweight or obese.”

You’ll no doubt be relieved to discover that the Government knows the cause all this fatitude and (even better) knows what to do about it. You see it’s all down to ‘lifestyle factors’. Translation: we eat too much fat and we don’t do enough exercise.

But the Government’s not just going to sit back and wait for the bills. They’ve got a four (no, not a five) year plan and it goes like this:

2010

  • Grants for “healthy lifestyle programs” in the community
  • “Public Awareness campaigns”

2011

  • Create Medicare Locals (GP centres) for delivery of preventive primary health care
  • More Public Awareness campaigns
  • More grants for healthy lifestyle programs in the community
  • States given money to implement healthy lifestyle programs in workplaces and schools
  • Awards for excellence in promoting healthy lifestyles

2012

  • Finish installing Medicare Locals
  • Money for more nurses and diabetes treatment
  • More Public Awareness campaigns
  • More grants for healthy lifestyle programs in the community
  • States given more money to implement healthy lifestyle programs in workplaces and schools

2013

  • More Public Awareness campaigns
  • More grants for healthy lifestyle programs in the community
  • States given more money to implement healthy lifestyle programs in workplaces and schools
  • Bonus payments for States that show we lost weight

That’s right, the plan is to nag us to death (or more precisely, to nag us to health). If you want to know what a “public awareness” campaign looks like when it’s at home, you need look no further than the recent “Measure Up” ads and posters.

According to a recent evaluation of that campaign, it was wildly successful. Now, by successful they don’t mean that there is any evidence that it had any effect on obesity or chronic disease. No, what they mean is that 91 per cent of us saw it.

The ads successfully told us we are too fat and we should do something about it. And thank goodness we have them because without all that advertising, we’d be forced to well, ah … use a mirror?

The government is backing up these ads with loads of new lifestyle programs and money for GPs to target ‘primary prevention’. You won’t be able to visit a doctor, go to work or enter a school without being nagged about your ‘lifestyle’.

Last September, the Royal Children’s Hospital in Melbourne published the results of a study into exactly how effective that kind of nagging is. The research team asked 66 general practitioners to administer advice “targeting change in nutrition, physical activity, and sedentary behaviour.” The advice was in accordance with the national healthy living guidelines.

In the study, 258 obese Melbourne children were randomly assigned to either an intervention or a control group. The children in the intervention group saw their GP four times over a 12 week period and received all the recommended advice about nutrition and exercise. The kids in the control group lived life as normal without any nagging from their doctor.

Twelve months later, the researchers checked in with the kids to see what difference it made. The result was that the counselling “did not improve BMI, physical activity, or nutrition in overweight or mildly obese 5-10 year olds.” The researchers went on to note that “and it would be very costly if universally implemented.”

In stark contrast, there are over 80 studies (and counting) which show that taking the simple step of reducing the availability of sugar sweetened beverages (soft drinks and juices) has a dramatic effect on obesity and chronic disease. This kind of evidence seems to have escaped the research powers of our health hierarchy. Because even in the face of unequivocal proof that the advice we give our children doesn’t work, we’re lining up for more of the same.

Telling people to exercise more and eat less fat is immensely costly (as the budget has just proven) and the evidence says it doesn’t work. But it appears that we are not about to let those details get in the way of a campaign designed to convince us the Government is doing something about health.

The definition of insanity is doing the same thing over and over and expecting a different outcome. Let’s stop the insanity on health.

Join the discussion 8 Comments

  • John Lake says:

    Hi David,
    I heard you for the first time tonight on ABC radio and it was a pleasure to hear you and your informative research. My name is John Lake and I am CEO of a non alcoholic beverage company in Australia that specialises in producing no sugar drinks. We absolutly believe this is the future and train/preach to all our distribution teams accross Aus pretty much what you stand for. The company “NZ Beverages” has a NZ dynasty but is Australian based and owned. My partner David Thexton is the guru behind us and I would look forward to all 3 of us having a chat at some time. Good luck with your book and your project. I for one will be grabbing a copy ASAP
    Cheers,John Lake.

  • Harry says:

    Great article David.

    Although I must point out that the research consistently shows that energy balance is the main factor in body composition (providing protein intake is controlled as a variable).

    Of course, seeing as sweetened food stimulates the appetite and is much easier to ingest in large caloric quantities than proteins and fats, it often leads to ad libitum over-feeding, which in turn leads to obesity.

    The real problem is what sugar does to diet compliance (not so much that it brings on biological armageddon with every spoonful). I think we need balance on both sides of the ledger here.

    Cheers

  • susiecol says:

    thanks for your article. I think people should be exercising but not using it as a weight loss solution. I know many people who exercise soley for the purpose of being able to get stuck into the coke and chips afterwards. It seems that nearly everyone knows that sugar may convert into a few extra kilos but no-one knows about possible other ill effects like heart disease. We need a campaign like the one against the much maligned saturated fat.

  • Al Gallo says:

    This is the messages I’ve sent to the groups I belong to:

    Subject: Let’s stop the insanity on health. Budget comments.

    I highly recommend this blog.
    The author wrote the book ‘Sweet Poison’, an impressive investigation of the abundant research regarding the use of sugar and the unsuspected effects of fructose, which is about half of this sweet, pervasive enemy.
    http://www.raisin-hell.com/
    Warm regards,
    Al Gallo

  • Thanks for all the comments! Its great to get feedback on my rantings!

    Harry the trouble with the energy balance argument is that while it is true that energy in must equal energy out the causation spruiked by traditional advice (that you should exercise to lose weight for example) is not actually there (its just as viable to say you should lose weight to exercise).

    It is more likely that energy consumption is changed by hormonal disruption (such as fructose or growth) and the result is a change in energy balance (which causes you to eat more). Its a point I think I need to expand on, so I’ll stop banging on about it here and do a blog post on it.

    Cheers
    David.

  • Harry says:

    Yep, agree with you 100% regarding the explanatory emptiness of the energy balance argument (e.g. “do more exercise”; completely ignoring that this may up-regulate appetite and feeding, thus leading to a greater net energy surplus over the day).

    You said:

    “It is more likely that energy consumption is changed by hormonal disruption (such as fructose or growth) and the result is a change in energy balance (which causes you to eat more).”

    No doubt energy consumption is influenced by hormones (anyone with hypo-glycemic sugar-cravings knows the truth of this, as do growing teenagers, bodybuilders on exogenous testosterone etc.).

    But the underlying physics remain: whatever diet promotes consistent energy deficits will promote weight loss, and vice versa.

    And here’s the take-home point for me – diets that promote ad libitum caloric deficits are diets that control satiety. This is why sugars are damaging to weight loss efforts; they impare long-term satiety, and thus de-rail dietary compliance.

    Again, if you factor out protein and calories (i.e. in hypo-caloric conditions), ward studies consistemntly show that macro-nutrient composition of diets is irrelevant.

    This does not imply that we should load up on sugars (to the contrary, as this will likley impair our ability to remain hypo-caloric, as it wil up-regulate appetite). It just means that dietary advice (i.e. “stay away from fructose”) is more about appetite control and satiety than about the intrinsic physiological effects of fructose.

    Looking forward to your post !

    P.S. I’m happy to concede that, in practical terms, we are in 99% agreement !

  • Pandit says:

    If Sugar has such an impact… imagine what Alcohal does to our body…. I am not sure if there is similar research done on this. Also if David went off Sugar and Alcohol both or no ?

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