The government is set to ban sugary drinks from schools. Given that one in three New Zealand kids are overweight or obese, you’d think that might make a professor of public health happy. But Professor Grant Schofield of AUT thinks the ban will do nothing measurable and — at worse, it borders on virtue signalling. He thinks that the trouble with these interventions is you look like you’re doing something but you’re not acting on the real problem. That is, the remaining 70-80% of school lunch boxes which are full of unhealthy, ultra-processed food.
Schofield’s research into New Zealand’s lunchboxes and shopping trolleys reveals the shocking state of our diets. The Feed's Vincent Heeringa asked him what can be done to reverse the picture.
Vincent Heeringa: Banning sugary drinks in schools is something you’d would support. I imagine?
Grant Schofield: I suppose, as a professor of public health, you have to say yes, right? Because the antithesis of that is pretty awkward. It’s like, I support them being in school, but I don’t think the question is necessarily subtle enough or the intervention is subtle enough to address the problem that’s going on. I’d go, yeah okay, good. You probably don’t want your six year old buying a Coke, at lunchtime, you know, but that’s probably not actually happening right now.
Is that alone is not going do anything much to change the problem we have with food and the lack of attention we’ve paid to our food supply, especially for our kid’s lunches. I don’t think it will do anything measurable.
In my view, I suppose in evolutionary biology terms, there’s a massive mismatch between what we eat and what we were designed to eat. So the sort of food supply that humans had for almost the entire time we’ve been on the planet doesn’t really exist. And you get particularly worried about kids, right, because they’re growing and developing and they need nutrients. We have essential nutrients and the question is in our current food supply, and the way we set up food do they actually get those. And if they don’t, are there consequences for that. And I think the answer is, yeah, there probably is.
VH: Let’s come back to the diet issue in a minute. You are saying that the new regulation that’s being proposed is probably reinforcing what already exists in most schools?
GS: I spent a bit of time being the chief health and nutrition advisor to the ministry of education, and I’d say that the bulk of primary schools have something around sugary drinks in their schools. Not all, but most. I’d like to find a school that’s still selling, you know, lemonades and Cokes and stuff in schools.
I think high schools are a different story. It’s more of a sort of commercial food supply, tuck shop situation. It resembles a dairy or a sort of local grocery store in many ways for the food supplies. I think it depends, depends on what you’re talking about.
VH: And do you know if this regulation applies to high schools?
GS: Yeah. That’s the idea?
VH: The impact of reducing sugary drinks has got to be beneficial, at least, if you think about tooth decay. But not just teeth, we know the impact of sugar on lifestyle diseases such as diabetes and so on. But what you are saying is that there really is the tip of a much bigger iceberg, which is that the entire diet of children needs to be addressed, not just this drinks component.
GS: Yeah. I think you end up with policy that’s window dressing basically. I don’t think it’s going to do much at all.
The broader category that sugar drinks fall into is what we call ultra-processed foods. And so it’s food that’s low in nutrients. So it’s generally low in protein and essential fats and it’s, you knows certainly lower than the essential micronutrients. But it’s high in energy, and it can often dis-regulate the way we would normally feel full. So there’s potentially an addictive component to some of those foods. There’s potentially the fact that glucose and insulin are raised and they go up and down and on this roller coaster of hunger and partial fullness. That sort of food is the problem.
You can talk about sugar drinks and dental decay. That’s an interesting thing. They’re definitely associated with that, but all refined, processed carbohydrates are associated with dental decay. it’s just part of the category. I think if we’re gonna have a reasonable discussion around food, we should have that. If COVID has taught us anything, it that we can act on health. We do care about our health, but strangely, not around our kids in this case.
VH: You’ve been looking at lunch boxes as part of a study. Tell me about that.
GS: I guess the word epidemiology has become a commonplace word since we’ve had COVID, but, we wanna do nutritional epidemiology, see what people eat and how it’s associated with their health. And if we change things whether their food changes. Part of the problem with kids is, you can go and ask their parents what they’re eating, it’s not a very good proxy. You ask the kids themselves that’s possibly even worse. And so you’re left with very few instruments. But I think the advent of the phone has really helped that. And so we’ve been popping into schools and, with the school and the kids and parents consent, is just whipping off photos of what they’re having for lunch. And then trying to see if we can do anything with those photos. We categorise it into four categories: whole food, you know, food that was obviously recent recently alive somewhere in nature, processed in a way such as cheese, dairy or something, through to a bit more processed, through to ultra-processed.
And I think what you see, actually surprised me. I’m a parent. I don’t particularly like making school lunches, I have been prone to checking in a packet of some sort. But actually the levels that I’ve seen were pretty high. So we’re looking at 70-80% of the food in kids’ lunchboxes falling into that ultra process category. I’d imagine that I wasn’t doing that well as a parent, but actually on reflection, I was doing pretty well.
VH: A model citizen!
GS: Well, no, I wouldn’t call it that! I think it probably varies quite a bit by poverty. So the kids that the poorest are actually eating the worst. We probably need to do more on this, but I’m sure their breakfast isn’t great either, if it exists. So a high energy, low nutrient lunch is not a great start to the day.
VH: What are these high processed or highly processed, packaged foods you’re talking about? Give us some examples.
GS: Doritos are great example, just chips and packets. Obviously there’s a whole bunch of drink of all sorts, but there’s ones that are masked up as being healthy, they’ve got healthy branding on them. You get these vegetable crisps, which are essentially just chips, but they contain one and a half percent vegetable extract or something. There’s actually lollies there’s cakes and biscuits. We’ve had those since kids have been kids in New Zealand, so those are pretty prevalent. Those types of things are obviously pretty high in refined, processed carbohydrate and sugar, lower in protein and lower and everything in terms of other nutrients.
VH: The continuum you talked about with the ultra high process at one end and whole food — recently live food at the other. How far along that spectrum, can you go before you would say, well, that is a bad food?
GS: I’m not sure anything’s a bad food in the sense. It’s just the ratio of it. I acknowledge that we live in a world where we’re not gonna all be eating fruits and vegetables, meats, and fishes that were just plucked off the tree or taken out of nature. So I think the ratio probably needs to change a bit. I reckon about 70 to 80% of what we’re eating — and there’s some adult studies where we look at just what sort of things are in people’s grocery carts, as well — would be about that proportion of ultra-processed food compared to whole foods. If we could completely switch that around, so it was 20 / 80, we would probably be in a better state.
Is it all bad? I suppose it’s not. There are some things you could argue about, like honey, which is a whole food, but actually pretty high in sugar, versus some protein powder, which is actually meets the definition of being an ultra processed food. So some of these things aren’t quite as clear cut as you think.
That said, I think the ratio is just way outta whack.
I think our guidelines around what’s healthy have confused people. We’ve wanted to concentrate on nutrients and sugar and carbs and fat. You have to go and read a food label, no one’s quite sure what’s going on, there’s arguments between the low-carb keto community, the vegans, the other more moderate people. There’s just all these sort of food debates. When in actual fact, a much easier template might be the ultra processed one.
It’s just like, it’s coming out of packets, there’s no resemblance to what humans have eaten from most of our time about on the planet. Fine to have that as a treat, now and then, it’s probably not going to worry you, but the bulk of what you eat needs to be actual food. I think there’ll be widespread agreement. I think the food industry would buy that. I think all of the different nutrition communities and the medical communities, that would unify us a bit.
VH: It’s kind of what Michael Poland said 20 years ago. If it’s food that your grandmother doesn’t recognise, it may not well qualify as food.
GS: Yeah. I’m really inspired by Michael, as you know, The Omnivores’ Dilemma and those other works. I think he overrode two generations of scientists as a journalist and saw some sense. So congratulations to him.
VH: The shift away from meat, which seems to be very much encouraged by lots of dieticians. And we are constantly getting a message also from an environmental point of view that we eat too much meat. One of the alternatives to meat is highly processed soy proteins and highly processed vegetable proteins, which if nothing else, come with so much more packaging. Would you say that that highly processed protein plant protein is in danger of falling into that highly processed category you talked about?
GS: Well, it’s not really in danger. It is. So you, you end up with this fake meat-like substitute that is apparently healthier than fresh meat. I think the jury’s still out on processed meat, but for fresh meat, I think there’s evidence that that its a food that we should be eating as humans. We’re clearly omnivorous and it contains a lot of essential nutrients. Farmed in the right way, it’s a food that is not only tasty, but good for us and especially good for our kids. And I think encouraging something other than that, is really negligent on the basis of the evidence. Okay. You might raise a good point. There’s this whole extra layer around methane and climate change. Now I’m no expert in that I don’t pretend to be. It’s hard to understand methane and CO2 and yeah, farming makes up a good deal of our emissions in New Zealand particularly. But then we feed 10 times the amount of people that we actually have and we do have sustainable electricity. And so the proportion probably looks worse than it is. Could we farm better? I expect we probably could and we should, and we will. But should we, that be a reason not to eat meat? I don’t think so.