A panel discussion on whether the “war on diabetes and obesity” can be won was especially interesting. The panellists, all acclaimed nutritionists, each voiced their conviction that by staying positive and looking for workable solutions, the forces of nutrition could indeed win this war.
Then Erin Boyd Kappelhof, managing partner of Eat Well Global, a food communications company, touched on how labelling should be a key “tool” for food companies and policymakers to use.
She said: “We can make a small difference in consumers’ everyday behaviour with front-of-pack nutrition labelling. In Singapore the health promotion board has such a wonderful example of positive logos that help consumers make better choices.”
The “small” differences and “positive” statements she mentioned are all well and good, but how long will it take for this gentle approach to take hold, especially when many of the causes of diabetes—starchy foods like rice and noodles, and a sedentary approach to exercise—are deeply ingrained in local culture and lifestyles?
Official estimates suggest that tiny Singapore will be home to 1m diabetics by 2030 unless something serious is done to address the disease, so the clock is ticking.
Professor Jeya Henry was on hand for a chat about this after the session. One of the region’s most pre-eminent authorities on clinical nutrition with a tremendous academic pedigree, he had been part of the panel discussion, where he appeared to take a tougher line on the responsibilities of stakeholders to address the diabetes issue. I asked him straight up if we were all being too soft in this war against lifestyle diseases.
“A part of the challenge is that if you use a draconian stick in Asia, people will just turn their back on your message,” he said. “Yet, on the other side of the coin, to be just pussyfooting around, in a softly-softly way, it won’t work. I think the answer lies somewhere between those extremes, where we can effect an actual transformation.”
He suggested that a more impactful approach could be taken by persuading consumers, instead of just encouraging them or even shaking a stick. A visual strategy could be useful to change consumer habits—perhaps on packaging, similar to how many regulators depict the harm caused by smoking on cigarette cartons, but more hard hitting than standard nutrition labels.
He said: “I don’t know what the visuals should be but maybe we could show that type-2 diabetes can give you ocular and renal failure. That is very impactful. The problem is that people still take [the risk of diabetes] very flippantly; there is no urgency to it.”
Indeed, in a part of the world where it’s not unusual for whole families to suffer from diabetes, many people see a diagnosis as “karma, or God’s will”, as Prof. Jeya puts it. Type-2 diabetes is usually invisible until a patient is tested for it, so imagery will lack the shock value of, say, the diseased lungs and gangrenous toes in tobacco warnings.
“To be frank, we need to get some very good PR agency to unpick the psyche of Asians, which is much more complex than meets the eye. What they find to be the central part of a consumer’s diabetes anxiety, we could use,” he added. This last point about tapping into a consumer’s anxiety is worth thinking about.
Governments, academics and the food industry are constantly uncovering new and improved tactics to fight against the disease, but I think such moves will only be able to have a definitive impact once this psychological X-factor is identified.
In Australia, health officials complemented their multifaceted approach to tackling tobacco with plain-label cigarette packaging showing shocking images in 2012. These new packs worked alongside public education schemes, quit lines, smoke-free buildings and heavy taxation. The country’s stark path has resulted in one of the world’s lowest levels of smoking.
Australian officials also recognised the important element of peer pressure, and were at the forefront in turning smoking into an acknowledged antisocial habit, even among fellow smokers. Such peer pressure could also prove to be an important tactic in fighting diabetes.
Food products themselves are not the cause of the diabetes problem; rather the disease is exacerbated by personal habits such as a lack of exercise and over-consumption of the wrong types of foods. But I do believe the individuals, organisations and public bodies tasked with conquering diabetes could take some tips from successful anti-smoking drives over the last decade, especially by adopting a more hard-hitting approach.
It is difficult to change people’s deep-seated habits, so we should put more emphasis on “persuading” consumers than just “encouraging” them to take the prospect of diabetes seriously. It’s time to fight tough to win this war.