Week 10 : Lecture 50: Public Health Battles: Translating Dietary Patterns into Global Policy

Hello and welcome dear learners to the NPEL course on nutritional epidemology a way towards a healthy life for the module 4 diet nutrient dietary patterns and decisive mmology for the chapter 50 we'll be talking about public health battles which are translating the dietary pattern in global policy. So we will cover here two case studies. One a case study is on the geopolitical food wars the world trade organization versus the Pacific Islands and the second case study will be on algorithmic shield that is nutrient prolifering versus the technical barriers to trade. So these two case studies will be taking you towards understanding the translating dietary pattern into global policy. The discussion for these two case studies will be more understanding the public health battles and there we will try to escalate and see that how the dietary patterns come up into the global arena. In the case study one that is the global geopolitical food war the world trade organization versus the specific highlands the setup of the global conflict. So we can say today we look at how multi-billion dollar food lobbies weaponize trade laws to crash the public health initiatives. Lot of public health initiatives are being crushed by these lobbies. And let's look at the real world geopolitical battle of SMA and the World Trade Organization that is WTO. Historically, Simoa had extremely low baseline incidence of metabolic disease relying on a traditional diet of reef fish and tarot. However, in the late 20, we come across that western agriculture nations begin exporting a ultra lowgrade highly inflammatory industrial bioroduct to a specific mutton flaps. What it is? It is the fatty belly sheath cut off the sheet carcasses and consisting upon 50% of pure saturated fat and a turkey tails. So you can understand how the history goes beyond these two things. So by 20,000 or you can say 20,000 this high fat waste product flooded the semon food supply priced far lower than the domestic fish. So domestic fish uh prices were very higher compared to this and where the population started to take it as the population diet quality scores plumbed the obesity soared to over 75%. And these were drastically towards gaining the increase in the obesity. Even the type 2 diabetes rate uh uh skyrocketed. They escalated like anything and the response the Samoan government took an aggressive step. The government had uh taken it because there was increasing number of this incident they passed a national law completely banning the import of mutton flaps to protect the public health. This was something a very alarming effect which made sometimes the population to think that this is a step that to be taken. This is a step that has to be more in favor of the public. But what is the finding that after taking the step what will happen? The geopolitical trade collision. Now the Samoan national law and the world trade organization here on the either side that the world trade organization what they say they objected they violation of the free trade and the corporate argument came like this is an very arbitrary decision and this is very unscientific barrier to the commerce and this was something actually which was ringing an attention okay but the Samoan national law they said that the ban lowgrade industrial meat imports to halt a catastrophic national diabetic epidemic. This is because they were having the evidence and that was really giving them a chance to ban the epidemological and the legal battle. In the step one, we will try to understand how the corporate trade challenge comes here. When Simon banned the meat, global agriculture export lobbies pushed back through the international trade bodies. So there was a back entry. They filed a formal dispute arguing that Samoan import ban violated the global trade laws. The defense rested on the reductionist chemistry. They said that meat is a natural source of protein and iron. Okay, you can understand over here how their proposition was. A country cannot single out a specific animal part as inherently toxic. And this was something which was hitting the mind of the people. This ban is scientifically arbitrary and illegal under the free trade treaties. So it was a global pressure which was being put and this was strategically coming as a very reductionist chemistry. The step two the legal level the WTO assession to join the global economy and access international trade markets. Similar was forced by the WTO to lift the import ban. This was something which was very very shocking for them. The global trade environment stripped the country of its power to directly block harmful food matrix at its border. And then the upstream epidemological action because they could not use a direct import ban under WTO law. Public health official had to pivot to an upstream environmental strategy. If they couldn't stop the supply, they had to change the domestic market dynamics. The government implemented targeted domestic sale taxes on a high fat important matrix while simultaneously subsidizing the local food, vegetable and fishing cooperatives to artificially lower the price of the protective food. So something which was very important that the government did was to put up in front the protective foods. Okay. And which is something a great strategy that was being seen and this is the epidemological action. So now as a student you need to understand a great lesson. The diets here are highly influenced by international trade and the trade laws and the global supply chain which is disrupting actually the mind. When free trade arguments remove a country's ability to ban harmful food, the government should not bend down. They should put up the prepositions which comes with the scientific evidence from the nutritional epidemologist which they must design a domestic fiscal policies which are very important to understand over here such as targeted sale tax and agriculture subsidies to reshape the food environment which is very important and that's how they can really protect the health of their own countrymen. Now the case study two, the case study two is an algorithmic shield nutrient prolifering versus the technical barriers to trade which is trying to understand how this is a shift and to set up the policy war you need to understand this case study in detail. Now let's look at Chile's historic law of food labeling and advertising. In Chile, this particular law of food labeling and advertising was facing an outofcontrol childhood obesity epidemic and Chile was driven with a mass consumption of ultrarocessed food. So ultrarocessed food was being seen as a problem in this country. The public health officials over here they did a great policy job. They designed a powerful policy solution and the solution was coming with like forcing companies to put large black octagonal stop sign warning labels which is very important and this was something which was a gamechanging. Okay. What did it really affect? It affect on the front of any packed food matrix that exceeded strict limits of added sugar, sodium, saturated fats or calories. So stop sign like uh stopping this was a swine actually which was given. So and this was something which was giving that the food packed food matrix was given in a cluster to understand that what is there which is carrying and furthermore any food carrying a black stop sign was legally banned from being sold in schools advertised in the school that uh it should not be sold and advertised on children's television or even featuring cartoon mascots on its packaging. So nothing was being seen that it should attract the children which was taken step and this is something a very beautiful step that the country has taken irrespective of going against the global market. They were trying to stop these people on attacking the children's health and there was an algorithmic policy shield which we can understand over here. One is like a raw packed food. It was clean and the WHO nutrient profile model and it was passing and failing. The passing was coming with a clean box where unrestricted sales, marketing and cartoon max were allowed which was something where you can say that they have cleared but something when they find that they are exceeding the strict limits of added sugar, sodium, saturated fats and calories. They were putting a black stop sign and this black stop sign was complete that they were banning this. They were banning it from the school. They were banning on the children's television. They were banning all this marketing and they were featuring that of the cartoon mascot and its packaging also banned. So it was literally failing over here. So you can understand like how this makes you to a clear thing of like how epidmological counterattack also came. The multinational corporate defense. This law directly threatened billions of dollars in corporate food sales. large multinational food companies, corporations and food exporting nationally immediately launched a massive legal challenge through what they it it it put through a WTO technical barriers to trade the TBT committee. They argued that the blacks stop signs were unfair and a barrier to the trade and relied on a single nutrient reductionism. And to attack they say that you are demonizing the whole food. Our processed milk drink has vital micronutrients. Vitamin D, calcium and so lot of things actually they were coming into their defense labeling it is danger because of added sugar is unscientific and misleads the consumer. So this was something actually which was like make a a very strong things actually which was coming in defense. So in the step two deploying the algorithmic shield to defend the law in international court Chileian scientists deploy a rigorous datadriven nutrient profiling system which was based more on the WH standard. They were very intelligent and very clearly they made a great study to understand this issue and instead of using a subjective choices they built an objective mathematical scoring algorithm which was giving them a base to fight. They proved that the metabolic damage caused by the liquid sugar metric that is insulin spikes, glycemic load, hippatic fat synthesis completely overwhelmed any minor biological benefits of added vitamins. And this was a proposition which was very successful in making the clarity to the international people where the systemic market shift was to be understood because the Chilean government defended its algorithm with airtight epidemological data. It won the battle. It won the legal battle. They were very succeeded over there to win this. And the impact was very revolutionary. And the impact was revolutionary because it rather than taking the sale hit of blacking the black spot stop signs of their boxes. Ford corporations voluntary reformulated more than 20% of the entire production inventory within 3 years. They removed thousands of tons of sugar and sodium from national supply before the product ever reached the supermarket shelves. Here there is a great lesson for you to understand. The lesson comes like translating the epidemological data into an very objective automated and front of pack policies. It is very important that one of the most powerful tools to be used to see that how you make the objective out of your data. Okay. By building such a rigorous defensible mutant proliferying system, government can withstand the corporate legal challenges, even the international legal challenges and force the food industry to improve the quality of product which is very important and this is something which I really want to make you clear that you need to make more strong force towards the food industry. the global lobby actually which is more on quantifying the things rather not the quality of the food products especially the manufacturing level you should target them and you should make them clear like how this shift is to be understood. So I want to give you finally from these two case studies what is very very important for you to understand and see that where a Samoan country versus a Chile in the beyond individual choices in the case study one the dietary pattern are heavily dictated by a macrolevel factors like international trade agreements import laws and supply chain. If an epidemologist only studies personal choice, they miss the primary drivers of the disease. So the primary drivers of the disease are very important to be concentrated over here. So this case study is beyond an individual choice if you try to take it more on the public health arena. Now the second case study will be more towards defeating the reductionism and the reductionism should be defeated with the data. As an epidemologist you have a lot of set of a data and with this data you can just see that how this case study from a country has to be benefited to see the larger health of their country people. The food industry regularly uses single nutrient claims. They are saying fortified with calcium, fortified with iron, fortified with vitamin B12 and whole lot of your packagings are going on and going on and they are forced for the people to consume it. So what you need to do to mask a harmful highly processed food matrix the epidemologist must use holistic nutrient profiling and the holistic nutrient pro profilling of algorithms to expose the claims and protect public health policy. Your aim should be more towards protecting the public health policy. Very important. And if you have this aim, you can really defeat the reductionist and the reductionist will be defeated only with the data set. Then the macrolevel professionalism to finally capstone the shift learners from looking at the microscopic level of nutrient and biomarkers to the macroscopic level of the international trade. So you should understand like how you have to clear your battle, how you have to prepare for your battle, how you have to make it more clear that your international trade, your national laws, your systemic structural changes should be understood to this profession and you should all work in a team in the prof public health where it needs to make your macrolevel professional with to be very clear in fighting such wars for the public health. Okay. So with this we have come an end to this chapter which is giving you more insights from the two countries and this uh uh case studies which are coming from Lancet and also from uh understanding you the implications like how the diet trade liberalization for data and health and the second case study of structural responses to a nationwide food labeling uh is made available here. So you can go in rigor to get in more details of this case study from this references. So with this we come an end to this chapter and putting you a bio here. Thank you very much. [music] [bell] >> [music] [music]