Yago has been lost in the aisles of the supermarket for more than half an hour. A week ago he would have finished shopping, but now he is scanning the barcode of each product before deciding whether to put it in the basket (or not). Something different is that you can understand, or interpret, what you read on your mobile screen: what do the amounts indicated by the app for saturated fats, sugars, salt, or various additives imply?
The procedure is simple: just scan the product with your mobile phone so that an app such as MyRealFood or Yuka tell us if it is healthy. However, not all use the same criteria so the same product can be valued differently depending on which one we use. Some are based on the NutriScore system, others assess the degree of processing using Nova, and others combine both algorithms. Another option is to assess how healthy a product is due to its additives, or depending on whether it is organic. In this sense, it should be remembered that additives are safe – which does not mean necessary – in the permitted doses. Neither is a product, because it is bio, which can be more sustainable, it is healthier. In other words, in their eagerness to simplify the task of making the purchase, these apps can generate even more confusion among citizens. And that to choose the healthiest products it may be easiest to identify those without a barcode.
However, like Iago, many people use these applications. And from the field of public health, many actions have also focused on improving nutrition labeling. However, the important thing is not whether one app or another is more reliable, but rather to stop transferring – once again – responsibility to the individual. It is very important not to blame people because, beyond individual choice, there are many other factors that condition our diet. There are a few commercial determinants of health that are very important.
The business determinants of health
Nutritional apps can serve as a good tool when choosing when making the purchase; however, they cannot become the primary public health tool to promote healthy eating. Any intervention that obviates the interrelation between social structure, context, and health will be ineffective at the population level. In fact, the challenge of eating continues to increase: one in five deaths it is due to an unhealthy diet. On a global scale, eating poorly already kills more than tobacco.
For this reason, the scientific community is urged to consider a different approach towards the commercial determinants of health. That is, always keep in mind that the industry uses strategies and approaches to promote products and choices that are detrimental to health. The same strategies that the tobacco industry has already used, and that work. And hence, to a large extent, the burden of disease posed by obesity, hypertension, or diabetes.
The food industry exerts its corporate influence through four different channels: 1) marketing, to improve the convenience and acceptability of unhealthy products; 2) actions of pressure groups, to avoid political actions against their interests; 3) strategies of corporate social responsibility, to divert attention and whitewash reputations; and 4) wide supply chains, to facilitate the access of these unhealthy products anywhere. That is companies use their advertising techniques, their economic means, their corporate social responsibility, and their influences on institutions and governments to modify the consumption preferences of the population. And faced with this, we cannot defend ourselves with nutritional apps or continue to pose nutrition as an exclusively individual issue.
Public health actions
Consequently, the World Health Organization stated, already in 2013, a battery of different actions and public health policies to the different territories. For example, apply a 20% tax on sugary drinks, and invest the proceeds in programs to reduce their consumption. If junk food were more expensive, people would consume it less. In Spain, the nutrition group of the Spanish Epidemiology Society pointed out some of these proposals as priority and urgent for Spain. It’s about making it as difficult as possible, and yet almost everything you can buy in supermarkets is ultra-processed foods. In addition, the policies in our country continue to be based on the self-regulation of the industry and on public-private collaborations, which maintains economic interests above the health of the population.
Without radical measures we will continue with the status quo that is driving this pandemic of non-communicable diseases (such as cardiovascular disease, diabetes, or cancer).
Julia Diez (@ JuliaDiez91) is a doctor in Epidemiology and Public Health and investigates inequalities, food and health.
NOURISH WITH SCIENCE is a section on diet based on scientific evidence and knowledge verified by specialists. Eating is much more than a pleasure and a necessity: diet and eating habits are right now the public health factor that can help us the most to prevent many diseases, from many types of cancer to diabetes. A team of dietitians-nutritionists will help us to better understand the importance of food and to break down, thanks to science, the myths that lead us to eat badly.