Philip James is rightly "scandalised by how quickly and how far Andrew Lansley, the health secretary, is handing public health over to the food and alcohol industries" (Department of Big Macs, 16 November). These are the same vested interests that have fuelled the obesity and alcohol abuse crises and are, as Seumas Milne points out, "as good as dictating terms at the heart of government" (The corporate grip on public life is a threat to democracy, 18 November).
All of us in the public health arena are likely to be in despair over this government's actions, especially since the increase in childhood obesity has now stopped. This is almost certainly because of a coherent, effective policy on diet, implemented by the Labour government following decades of opposition from the food industry. The idea that those whose stated policy is maximising profit from the consumption of sugar, salt and saturated fat should now be given power to shape policy would be laughable were it not so scary.
As I explain to GPs who attend the University of Surrey's nutritional medicine programme, it has been a long, hard struggle to achieve an informed and effective national strategy for diet and health. A parliamentary initiative in 1904, the inter-departmental committee on physical deterioration, set the ball rolling. It was convened to investigate why there were not enough recruits of sufficient height and strength to fight in the Boer war, and it identified widespread malnutrition in urban working-class children and started a targeted free-school-meals programme.
Other initiatives followed, culminating in the second world war food, nutrition and education policy, which achieved the restoration of adult height to acceptable levels. This happened through enlightened science-based policy in which Britain led the world. Indeed the Ministries of Food and Health won an award in 1947 from the American Public Health Association for its wartime policies.
Unfortunately, with postwar affluence, interest in public health waned. When the Thatcher government was forced to respond to the growing epidemic of heart disease and looked for suitable dietary guidelines, none existed.
The National Advisory Committee for Nutrition Education did eventually highlight widely known issues in relation to sugar, salt and saturated fat, and proposed guidelines, but scandalously the food industry, through its public face, the British Nutrition Foundation, connived to block the report. Only after an outcry in newspapers and the Lancet was it published in 1983. Even then no minister of health would endorse it until the Blair government, by which time the obesity and diabetes epidemic was out of control.
By the end of the Labour government, in full co-operation with the food industry, a sensible policy and programme had emerged. These initiatives appear to be working, given recent evidence that prevalence of obesity is falling in girls and no longer increasing in boys. The lesson is that if the science is put as the main driver of policy, with the food industry encouraged to participate in initiatives, then everyone benefits. Lansley's plan to put the food industry in the driving seat will throw away a century of slow and tortuous progress.
