Q&A with David Stuckler – guest editor of PLoS Medicine series on Big Food

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Following the launch of the PLoS Medicine series on Big Food and the publication of the first three articles in the series last week, I caught up with one of the guest editors of the series, David Stuckler, University Lecturer in Sociology at the University of Cambridge. I asked him a bit about his research background and some of the issues related to the PLoS Medicine series on Big Food.

Why is it important that a major medical journal examine the food industry and its influence in global health?

Put simply, our global food systems are failing to meet the world’s dietary needs. To understand why, it’s necessary to look at who are the main players – increasingly it’s large, powerful multi-national companies.

Just like to deal with tobacco you have to address tobacco companies, so too when dealing with dietary issues is it necessary to deal with global food companies and the markets that power them.

PLoS Medicine is, to my knowledge, the only leading medical journal that doesn’t take industry funding. So it is uniquely placed to publish independent views. It was disheartening to find in the course of guest-editing the Big Food series that it was so difficult find nutritional experts in low- and middle-income countries who were not already affiliates of multi-national food companies.

Why is this an international issue and not one limited to developed countries?

All the dietary problems that dominate the discussion in the US and UK – obesity, diabetes, heart disease – are now present in developing countries. The difference is that there is little or no public health voice to respond. Low- and middle-income countries have the opportunity to learn from the mistakes of the West. But they face enormous pressure to do otherwise.

How does your training as a sociologist inform the examination of Big Food?

Sociology focuses on the hidden forces that affect our lives. It addresses power, politics, and inequality; the “causes of the causes” of ill health. To address unhealthy food systems requires more than just answering technical questions of medicine and epidemiology. It also involves tackling underlying economic and political problems. We need new methods and tools to tackle these, and sociology and political economy have a wealth of insights to offer.

Some of your previous work has focused on the influence of Big Tobacco and Big Pharma in the global health arena. At what point in your career did you first start thinking about the food industry?

When I was working on Master’s in Public Health at Yale, I took a course on Global Chronic Diseases. As students we could see the similarities between tobacco and food debates. At the time, the Sugar Association had written a letter to WHO threatening to lobby the U.S. to cut its budget if it did not change its strategy on Diet, Physical Activity, and Health. It was clear that we faced a long, uphill battle to improve global nutrition.

What further research is needed in this area?

We need to know more about the addictive properties of food and how to build a case for effective legislation and regulation. Similar to how public-health battles on tobacco played out in the courts, it is likely that food issues will end up there too. There is also a need for consensus on how to interact with industry so to improve health and nutrition. Many public health and medical schools take money from Coca-Cola or PepsiCo as well as other sources with questionable records like ExxonMobile and Monsanto – is this acceptable? As much as we study individual risks, we equally need to apply our rigorous scientific methods to understanding population risk factors. This includes gaining a much better understanding of how to deal with the powerful influence of corporate interests on public health.

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Dr Stuckler’s book, Sick Societies: Responding to the Global Challenge of Chronic Disease, is now available from Oxford University Press, covering the social, political, and economic aspects of heart disease, diabetes, and leading causes of death worldwide.

The PLoS Medicine series on Big Food examines the activities and influence of the food and beverage industry in the health arena.  The series runs for three weeks beginning 19th June 2012 and all articles will be collected at www.ploscollections.org/bigfood. There will be a tweet chat with David, the other guest editor Marion Nestle, the senior Magazine editor Jocalyn Clark, and author Raj Patel on Wed June 27 at 1pm ET. hashtag #plosmedbigfood

 

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