If you walk into virtually any convenience store across Australia, you will be surrounded by wall-to-wall sugar. Row upon row of confectionery in all forms and sizes: highly-sugared soft drinks, yoghurts, ice-creams, snacks and breakfast cereals. As you move towards the counter, even more appears, crowding your view. And as you pay, the cashier reminds you of the chance to buy three more "treats" for the cost of two.
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You go along the street to your favourite café - the offerings change, but the sugar content doesn't: muffins, cookies, lines of delicacies jammed into the top row of the glass display cabinet.
Ultra-processed food and beverage manufacturers along with their trade associations, who prioritise profits way, way ahead of people ... are squarely to blame for the very poor diets and the resultant poor health of millions of Australians.
You drive to - or through - one of the many fast-food outlets in your suburb and are surrounded by their visually appealing offerings, each one containing more calories than the last.
You walk into the supermarket, and there are two places that catch your eye: the checkout - where unhealthy food items are nearly eight times more likely to be discounted than healthy food items - and the end-of-aisle displays. Here, again, unhealthy goods like chocolate and confectionery, chips and unhealthy drinks are designed to capture your attention and get you to reflexively stretch your hand and grab a packet.
These junk foods are officially known as ultra-processed foods and beverages. They almost aren't food at all, being made mostly from substances extracted from foods, such as fats, starches, and added sugars. They usually contain additives like artificial colours, flavours, and preservatives. Examples of these foods are breakfast cereals, frozen meals, sweet biscuits, soups, sauces and dressings, processed meat and seafood, fast food, cakes, ice cream, frozen desserts and salty snacks. They include drinks too, like sports and energy drinks, soft drinks, juice drinks and nectars, and ready-to-drink tea and coffee. Just as we see in the UK and the US, ultra-processed foods have taken over our shopping baskets here in Australia.
In the Australian population nearly half of our energy comes from these ultra processed foods. Older children and adolescents are at greater risk as they get more than half of their energy intake comes from these so-called foods and drinks.
Exploiting our addictions
This is all the result of a big game that has been going on for the past few decades, where we, and especially our children, are being programmed by the ultra-processed food and beverage manufacturers and their retailers. In Michael Moss's new book Hooked: Food, Free Will, and How the Food Giants Exploit Our Addictions, the Pulitzer Prize-winning US author shows how "Big Food" is constantly innovating to manipulate and increase addiction-intensifying sensations in their products. They spend millions to design their products, generate their brand and market power, advertise to your children and to you. Then manufacturers and supermarket chains battle it out to make sure the most addictive products are placed prominently in-store, and that they're discounted so cleverly that you reckon you're getting a great deal.
Australian advertisers are highly inventive and innovative, and they get their highly persuasive messages to our children and to us through both traditional media and social media. The average Australian 5- to 8-year-old is exposed to over 800 unhealthy food advertisements on TV each year. The kings of Australian sport also double as the ambassadors of junk food and drinks. We should ask ourselves, why do sports promote such unhealthy messages?
More insidious is the advertising on social media, as it is more hidden from parental view. In many of the games children are enticed to play they are rewarded in exchange for time spent viewing full-screen ads. This form of advertising is so effective it can get children to choose a previously unfamiliar confectionary brand. As a parent you probably have no idea how much your children are being influenced by junk food advertisers.
There are some pretty startling facts about the illnesses associated with the diets we've been advertised into: diabetes, heart disease and cancers being the main ones.
An estimated 4400 Australians a year have a foot or leg amputated due to diabetes. Imagine the headlines if this were caused by landmines. Diabetes is also the leading cause of blindness in working-age Australians. A quarter to a third of the estimated 1.8 million Australians with diabetes will develop eye disease. Imagine the outrage if this was result of a chemical spill.
What can we do about it?
So much of this is preventable. Diabetes is not inevitable. There are so many things that all of us across our community can be doing to prevent or alleviate this problem.
What can supermarkets do? They can provide much healthier checkouts that don't display chocolate, confectionery and soft drinks; place healthy food at end-of-aisle displays; allocate less shelf space to unhealthy items relative to healthy food and beverages; and they can offer fewer or lower discounts on unhealthy products.
What can sporting associations do? They can offer healthy drinks, pre-packaged snacks and sandwiches while still making healthy profits to keep their clubs running.
What can governments do? When they make health policy, they can set nutritional guidelines excluding the corporations and their trade associations from these discussions. These entities are too compromised by conflicts of interest to be allowed to participate.
Governments can also substantially limit the advertising of junk foods and drinks to children - as has been done in the UK and elsewhere. They can develop effective front-of-pack labelling to guide shoppers to healthier alternatives. They can introduce a levy on sugar sweetened beverages that has been adopted in 50 countries. This could then be used to support sporting associations rather than letting junk food and drink corporations sponsor them (as we did with taxes on tobacco).
They can institute effective, well-researched, long-running media campaigns that have worked so well with tobacco, road trauma and the prevention of skin cancers.
What's holding us back?
So, with all that can be done, why is so little happening? What is stopping Australia from protecting itself against diabetes?
The major cause isn't lack of hospital beds, or treatment, or ambulances - the giant elephant in the room is Big Food. This is the constellation of ultra-processed food and beverage manufacturers, along with their trade associations, who prioritise profits way, way ahead of people. In my view they are squarely to blame for the very poor diets and the resultant poor health of millions of Australians. We know from our experience with the tobacco industry that the greater the corporate influence, the less effective public health policies.
I have my own stories about the power of the junk food and drink companies. In 2008 I was asked to chair the National Preventative Health Taskforce, and we were tasked with developing a strategy to reduce the damage done to Australians from poor diets, lack of physical exercise, tobacco and alcohol. We didn't have to speak to the tobacco companies (they had been completely discredited by this stage) but we did have to include the junk food and fast food companies, as well as the alcohol companies.
At the time I thought maybe their oft-cited mantra "we are part of the solution" was correct. But since then, over the past 13 years, all I have seen are these corporations and their trade associations delaying, lobbying, obfuscating and casting doubt on well-established science to undermine the implementation of effective measures to reduce the harm of their products.
Not unlike the way fossil fuel industries have undermined global (and local) efforts to diminish global warming. How do they do it? By using their lobbyists, who tread the corridors of power in Canberra in their hundreds, and through political donations.
So much so that many of our political leaders fear the corporations (and their PR, legal, tax and advertising and media cronies) more than they fear the voters (who actually are in favour of change). Interestingly, over the past 13 years, Australia has done well in reducing tobacco smoking (thanks to the lack of involvement of Big Tobacco in setting policy), and has done so poorly in reducing harmful diets and alcohol consumption.
You can make a difference
Given the institutional paralysis, it's up to us as individuals and communities. What can we do? We can learn about unprocessed and minimally processed foods (they are the ones you need in abundance) and avoid ultra-processed foods.
We can learn to be careful in supermarkets, to stick to the fresh produce sections, avoid the end-of-aisle and checkout promotions or the convenience store cashier who has been told to invite you to consume as much junk as possible.
As individuals, and even more effectively as communities, we can insist our children's schools and sporting clubs serve healthy food. We can advocate in parent groups to our local, state and federal governments to minimise the saturation levels of junk food advertising to Aussie kids.
Diabetes is not inevitable. But it will spread even more in Australia as long as we continue to live in our sugared and ultra-processed society.
Diabetes prevalence, the loss of legs, the blindness, the associated heart disease and the premature deaths will stay with us unless we change our food environments, reduce the saturation level of advertising directed at our children, and kick the junk food manufacturers and retailers out of our national and local policy-making.
- Professor Rob Moodie is deputy head and professor of public health at the University of Melbourne's School of Population and Global Health.
