It was suggested in a recent Sherbhert article that the obese people of the UK population may need more protection from Covid-19 (CV) than the over 70s. Another Sherbhert article highlighted a report headlined “Time for an honest conversation about weight” in the Daily Telegraph. And on 30 April a report appeared “Obese patients 40pc less likely to survive virus”. There are many more references publicly being made to the linkage of underlying bad health due to obesity – that is in large part diet – and deaths in the UK, not just from CV, but also more deadly conditions such as heart disease.
In addition, recent reports refer to the higher rates of CV related death among the poorest in society than among the affluent – poverty and poorer health, it has long been known, go hand in hand, as do bad diet and poorer health. The poor health of citizens puts pressure on the NHS, and that poor health is so often self-inflicted. Among the good things to come from the CV pandemic perhaps should include a strategy to tackle that health issue specifically, including, as perhaps the most important, changing the diet of much of the nation.
OBESITY – TAKING WEIGHT OFF PEOPLE TAKES WEIGHT OFF THE NHS AND THE DEATH RATES DECLINE
Nobody has ever disputed the need to protect the NHS, keep the NHS healthy and avoid it being overwhelmed, long before CV came along, but now a mantra due to CV. The pressure on the NHS has always really been caused through carelessness for it, citizens failing to take responsibility for it, pushing that on to Governments. That may have changed if lessons were to stick: during the time of CV, A&E has, it is reported, been used perhaps 50% less than normal. There will be several reasons but perhaps one is that many citizens have realised that the condition they might otherwise have taken to the NHS is one they can in fact manage. So too with attending a GP. If this new resilience holds, then that will be a benefit.
However, it is said that 60% of the UK population is overweight. A huge number of people – rich and poor – are obese, and child obesity is rife in the UK – that being primarily the responsibility of parents. The UK is the most overweight country in Europe (which is not helpful when trying to keep down deaths due to CV). Obesity is behind or highly contributory to a number of conditions such as type 2 diabetes and heart disease. These conditions put huge pressure on the NHS. If obesity were eradicated or substantially reduced, the NHS would be healthier itself and better able, with resources freed up, to combat other deadly or debilitating conditions. While it is unavoidable to say that an individual’s obesity is ultimately their own choice and responsibility in most cases, the framework in which human nature and weaknesses are exploited for gain by food manufacturers and sellers of food and drinks, through intense marketing and lifestyle selling as well as almost addictive products, is established and promoted by the whole of society itself.
Even the experts and the NHS are infected: apparently half of NHS staff are overweight, and 25% of nurses are obese. NHS hospitals dispense vast amounts of junk food and drinks, sold on the premises. A crucial indisputable cause of obesity and related illnesses is woefully bad diets: largely comprising packaged, chemically messed about with, food, stuffed with things to make the consumer want more, devoid of necessary nutrients, high in sugar content – let’s call this highly processed food “non- food”. Supermarkets are full of them. Take away food is currently mostly non-food. Even some food served up in cafes and restaurants is non-food. It took many years and deaths to have the connection between tobacco and deadly diseases understood and to convince a heavily smoking public to change its ways: but there has been some success, and achieving it involved some drastic steps and vivid displays of the devastation of the human body caused by tobacco smoke. The battle to change the nation’s diet is a similar one. The CV crisis is highlighting that bad diet is a real killer in UK society and perhaps that, as much as anything else, is responsible for CV’s potency in Western Europe and the United States when compared to elsewhere.
THE MOST DEPRIVED PEOPLE – SOME 0F THE MOST UNHEALTHY – SUCCUMB WORST TO CV
The last few days has seen a public focus on the rate of CV deaths being considerably greater in the poorest locations of the UK than in more affluent areas. The multiple can be debated but the reality that it is always the poorest who suffer the worst health consequences is well known and needs real attention. It seems that the death rate among certain BAME people (Black, Asian and Minority Ethnic) is considerably higher than among the white population. It seems that black Caribbean origin people are suffering a highly disproportionate death rate from CV. It is said that BAME people have a 3 to 4 times greater propensity to metabolic syndrome than Caucasians (Metabolic syndrome caused by excess body fat is a combination of conditions – high blood pressure, excess fat at the waist, high blood sugar and abnormal cholesterol). Metabolic syndrome is in large part attributable to non-foods and so non-foods are big drivers behind type 2 diabetes, high blood pressure, strokes and heart disease and may be contributors to dementia and cancers. There are high numbers of BAME people in certain deprived urban areas, which have the worst death rates from CV in the UK. For example, Newham in London is 78% populated by ethnic minorities, 48% of people there are in poverty, and it has the highest CV death rate.
Health inequality – where the poorest in society suffer worse health issues than the wealthier- is an established problem and too complex for this article, which is not to diminish its importance. The worst hit are the poorest people in certain densely populated urban areas. The CV crisis is bringing a much- needed spotlight onto this saddest of issues. There is believed to be a high rate of obesity and morbidity syndrome among these people, who live largely off non-food,
Poor diet, it is believed, is, among others, a major factor behind health inequality and so behind the tragic death rate from CV in deprived areas.
A STRATEGY FOR HEALTH
As if this is news, CV has brought home to people in a stroke that health is what is most important to them. Yet that to date has not been matched by behaviour, particularly around consuming real, nutritious food rather than non-food. Good food need not be more expensive than bad, and it is not a rich man’s province. If CV gets controlled, now is the time for a concerted strategy to change the nation’s approach to getting and staying healthy. That is a strategy which would improve the quality of life for individual citizens.
A massive and intense campaign of education and messaging which is totally unambiguous that non-food kills and disables and destroys quality of life, as well as crippling the NHS, is required. Non-food manufacturers and sellers need to be regulated toughly to not deceive, but rather to be transparent with, the public as to the damage non-food does. Health warnings and a similar approach in attitude to that towards tobacco need to be considered. Incentives to move to good food, and disincentives to purchase non-food will be necessary. Good food has to be made available, accessible and affordable. A seriously funded and reputable body with real powers and strong individuals to deal with the nation’s dietary change is needed. A simple start tomorrow would be to bar non-food from all healthcare facilities.
This a chance to embrace real change for the better through an aggressive national diet strategy to replace non-food with good food.