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I SI B
SNB N1 -18-58358338-37-0720-24- 4
Minds and Markets
www.earthscan.co.uk
www.earthscan.co.uk

9 9 781853
781853837029
837029
Tim Lang and Michael Heasman
34755_c-1.indd 1 18/06/2009 14:12:42
FOOD WARS
Michael Heasman dedicates this book to Mum, Dad, Susan,
Colin and Jason

Tim Lang dedicates this book to Anna and Alfie and

their generation’s future
 FOOD WARS
THE GLOBAL BATTLE FOR MOUTHS,
MINDS AND MARKETS

Tim Lang and Michael Heasman

London • Sterling, VA
First published by Earthscan in the UK and USA in 2004
Reprinted 2004, 2005, 2006, 2007, 2009

Copyright © Tim Lang and Michael Heasman, 2004

All rights reserved

ISBN: 978-1-85383-702-9

Typeset by JS Typesetting Ltd, Porthcawl, Mid Glamorgan

Cover design by Declan Buckley from a painting by William Crozier
(Joie de Vivre, private collection)

For a full list of publications please contact:

Earthscan
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22883 Quicksilver Drive, Sterling, VA 20166-2012, USA

A catalogue record for this book is available from the British Library

Library of Congress Cataloging-in-Publication Data

Lang, Tim.
Food wars : the global battle for minds, mouths, and markets / Tim Lang and
Michael Heasman.
p. cm.
Includes bibliographical references and index.
ISBN 1-85383-701-6 (hardback : alk. paper) — ISBN 1-85383-702-4
(pbk. : alk. paper)
1. Nutrition policy. 2. Food supply.
[DNLM: 1. Nutrition Policy. 2. Diet. 3. Environmental Health. 4. Food
Industry. 5. Food Supply. 6. Nutrition Disorders. WA 695 L271f 2004]
I. Heasman, M. A. (Michael Anthony) II. Title
TX359.L36 2004
363.8–dc22
2003022771

Earthscan publishes in association with the International Institute for Environment

and Development

At Earthscan we strive to minimize our environmental impacts and carbon

footprint through reducing waste, recycling and offsetting our CO2 emissions,
including those created through publication of this book. For more details of our
environmental policy, see www.earthscan.co.uk

This book was printed in the UK by CPI Antony Rowe.

The paper used is FSC certified.
 CONTENTS
List of Figures, Tables and Boxes ix
Acknowledgements xiii
List of Acronyms and Abbreviations xvii

Introduction 1
Why Food Wars? 4
Are radical options in food and health feasible or
even possible? 5
An outline of the book 8

1 The Food Wars Thesis 11

Introduction 11
Food policy choices 13
Key characteristics of the food supply chain 15
The war of paradigms: time for a new framework? 16
The Productionist paradigm 18
Two new paradigms of food supply? 20
The Life Sciences Integrated paradigm 21
The Ecologically Integrated paradigm 26
The three paradigms summarized 28
Which will dominate? 30
The place of food and health in the ‘paradigm’
framework 34
The Life Sciences and Ecologically Integrated
paradigms’ approaches to health 37
Ending the Food Wars through policy and evidence 40
Capturing the consumer 41
Evidence-based policy? 42

2 Diet and Health: Diseases and Food 47

Introduction 48
The nutrition Transition 53
VI CONTENTS

Two categories of malnutrition: underfed and overfed 60

The obesity epidemic 63
Calculating the burden of diet-related disease 70
Food safety and food-borne diseases 85
Inequalities and food poverty 89
The changing meanings of food security 92
Food poverty in the Western world 95
Implications for policy 96

3 Policy Responses to Diet and Disease 98

Introduction 99
Changing conceptions of health 100
Changing conceptions of public health 101
The nutrition pioneers: a 100-years war 103
A more sophisticated approach to food and nutrition 106
Post-World War II advances in social nutrition 108
Public health strategies: targeting populations or
‘at risk’ groups? 109
Dietary guidelines and goals 111
The dietary guidelines battle in the US 113
The case against the Western diet 115
A new approach to the relationship between food,
diet and health 117
Obesity: a case study of battles over policy responses
to a problem 120
Public policy responses to obesity 121
Industry response 123

4 The Food Wars Business 126

The battle for commercial supremacy in the food
system 126
The origins of the industrial food supply 128
Why ‘health’ is important to the food industry 134
The changing context for the global food economy 135
Remarkable changes in agriculture and food
production 137
Understanding the modern food system 139
The emergence of food company clusters 141
Farming becoming ‘irrelevant’ 147
A new ‘health’ colonialism? 151
The global scope and activity of food processors 153
 CONTENTS VII

Long-term structural change in food manufacturing

and processing 155
Changing company cultures for the 21st century 157
From globalization to localization 158
Rapid consolidation and concentration in food
retailing 160
Food retailers and their suppliers 164
The scale of the food service industries 167
The politics of GM biotechnology and the growth in
organics 173
Summary and conclusion 182

5 The Consumer Culture War 184

The battle for mouths and minds 184
Food and health: a done deal for the consumer? 186
Consuming wants and needs 188
‘Burgerized’ politics 189
The new consumer web and competing models 192
‘Schizophrenic’ consumers? 194
Moulding food culture 197
Food advertising and education 198
Obesity: redefining food marketing 203
Cooking and food culture 207
Shopping, spending and food 209
Food activism and the role of NGOs 210

6 The Quality War: Putting Public and Environmental

Health Together 214
Introduction 215
Can consumers save the planet? 218
Intensification 219
Food and biodiversity 221
Water 224
Pollution and pesticides 225
Waste 228
Soil and land 229
Climate change 230
Urban drift 231
Energy and efficiency 233
Eating up the fish? 242
Meat 248
VIII CONTENTS

Antibiotics 248
Keep eating the fruit: a UK case study 250
The clash of farming and biology: have humans got
the wrong bodies? 254

7 Food Democracy or Food Control? 257

Why is governance an issue? 258
Civil society emerges 262
Building on existing policy commitments 263
How global institutions frame food and health 265
Global standards 267
Injecting health into regional institutions: the
EU case 269
Agriculture, subsidies and health 271
Injecting the new health into national institutions 275
The emerging battle lines: food democracy versus
food control 279
Human liberty and consumer choice 280
Conclusion 281

8 The Future 283

Introduction 284
Which paradigm will triumph? 285
The paradigmatic analysis 289
Questions emerging from civil society 293
What of the future? 300
Looking for a political lead 301

Notes and References 308

Index 358
 LIST OF FIGURES, TABLES
AND BOXES

FIGURES
1.1 A simple version of the food supply chain 14
1.2 The era of the Food Wars 18
1.3 Productionist approach to health (1950s to present,
with ‘health education’ included post 1970s) 35
1.4 Life Sciences Integrated approach to health 38
1.5 Ecologically Integrated approach to health 39
1.6 The food policy web 45
2.1 Number of deaths by WHO regions, estimates for 2002 54
2.2 Leading causes of mortality, by age, 2002 55
2.3 Anticipated shift in gobal burden of disease
1990–2020, by disease group in developing
countries (WHO) 56
2.4 Diet of a well-nourished Chinese adult
(2500 kcal/person/day) 57
2.5 Diet of an under-nourished Chinese adult
(1480 kcal/person/day) 57
2.6 Relationship between the proportion of energy
from each food source and GNP per capita, with the
proportion of the urban population at 25 per cent,
1990 58
2.7 Relationship between the proportion of energy
from each food source and GNP per capita, with the
proportion of the urban population at 75 per cent,
1990 59
2.8 Life cycle – the proposed causal links 62
2.9 Number of under-nourished by region, 1996–1998 62
2.10 Obesity in adult population across OECD countries 65
2.11 Global population affected by underweight and
obesity in adults, by level of development, 2000 66
X LIST OF FIGURES, TABLES AND BOXES

2.12 Burden of disease attributable to ten selected

leading risk factors, by level of development
and type of affected outcome 74
3.1 Nutrition, health and economic growth 103
3.2 Shifting a population in a healthier direction: a
hypothetical example of fat intake 110
3.3 An integrated approach to food, nutrition and health 117
4.1 Food industry within the paradigms 129
4.2a–f Diets around the world – proportion of energy
derived from different foodstuffs determined by
different regions’ relative stages of development
(a: USA; b: EU; c: Latin America and Caribbean;
d: developing Asia; e: North Africa;
f: Sub-Saharan Africa) 130, 131
4.3 Grain per person, world, 1961–2003 137
4.4 The UK food added-value chain 2001 143
4.5 Anticipated growth of concentration in
European food retailing (by sales), 2000–2010 162
4.6a–bYum! Brands, global reach by fascia, 2002
(a: sales in international restaurants;
b: international sales by brand) 171
4.7 Global area of transgenic crops, 1996–2001 179
5.1 Model of consumer food aspirations used by a
leading UK food retailer 196
6.1 WHO environmental hazards and risk factors 217
6.2 World fisheries production, 1996–2001 245
6.3 Global marine fish catch, by region, 1975–1995 246
6.4 Decline of UK household fish consumption,
1950–2000 247
6.5 UK production area of fruit and vegetables,
1990–2001 252
6.6 UK fruit and vegetable consumption, 1975–2000,
with COMA targets to 2045 253

TABLES
1.1 Features of the Productionist paradigm 29
1.2 Features of the Life Sciences Integrated paradigm 31
1.3 Features of the Ecologically Integrated paradigm 32
2.1 Some major diet-related diseases 51
2.2 Types and effects of malnutrition 61
 LIST OF FIGURES, TABLES AND BOXES XI

2.3 Projected trends in under-nourishment by region,

1996–2030 63
2.4 Global increases in the prevalence of childhood
obesity 67
2.5 DALYs lost by cause, for the developed and
developing countries, 1990 and 2020 72
2.6 DALYs lost by selected causes, for the EU and
Australia, around 1995 73
2.7 Growth of expenditure on health, 1990–2000 76
2.8 Economic costs of diet- and exercise-related health
problems, US 77
2.9 Age-standardized deaths per 100,000 population
from CHD selected countries, 1968–1996: men 79
2.10 Age-standardized deaths per 100,000 population
from CHD selected countries, 1968–1996: women 79
2.11 Cancers preventable by dietary means 82
2.12 Numbers of people with diabetes, by region, 2000
and 2010 84
2.13 Some pathogenic organisms associated with public
health, which may be transmitted by food 88
3.1 The Eurodict Project population guidelines, 2000 116
3.2 Individualist and population approaches to food
and health 119
4.1 Directions of change in diet, food supply and
culture 142
4.2 Concentration in the US food processing sectors 145
4.3 The banana supply chain 151
4.4 World’s top 50 food groups, 2000 154
4.5 Leading global food retailers, 2002 161
4.6 Europe’s leading retailers, 2001 162
4.7 UK food retail market share (%), 1900–2000 166
4.8 World food service outlets by region, 1995–2000 168
4.9 World food service outlets, by value and type,
2000–2004, US$ 169
4.10 Burger King global presence, January 2002 170
4.11 Global top five countries by number of
McDonald’s outlets, 2003 172
4.12 Organic farming in Europe, 2000–2001 176
4.13 World markets for organic food and beverages 177
5.1 Competing models for patterns of food
consumption 193
5.2 World consuming classes 195
XII LIST OF FIGURES, TABLES AND BOXES

5.3 Adspend by food category, UK 198

5.4 Adspend by leading food companies in top 50
UK brands 200
5.5 Adspend by leading food companies, US 202
5.6 Leading food companies exposed to ‘obesity risk’,
2003 205
6.1 Environmental factors affecting health 226
6.2 Energy used by product/packaging combinations
for peas 234
6.3 Energy use and emissions for modes of freight
transport 234
6.4 Energy used per year by various UK food
industries 235
6.5 Energy input in US maize production, 1945–1985,
in MJ/ha 236
6.6 Emissions and energy use by modes of freight
transport 236
6.7 A simple dinner at home 238
6.8 Weekly costs of food and drink in the UK (organic
and non-organic) 243
7.1 Multi-level governance in relation to food and
health 259
7.2 Global institutions involved in food and health 260
7.3 List of global commitments 264
7.4 Farm subsidies by country; OECD Producer
Support Estimate, 1986–2001 273
7.5 US federal subsidies to agriculture, 1997–2001 274
8.1 Different approaches to food and health policy, by
paradigm 286
8.2 Features of the Productionist paradigm under
contest in the Food Wars 292
8.3 Some tentative rules for food and ecological
health (adults) 303
8.4 Some broad policy options for tackling food and
health 305

BOX
4.1 A brief history of Nestlé 157
 ACKNOWLEDGEMENTS
This book has been a long time in gestation. We began to talk
seriously about it in the run-up to the December 1999 Seattle
World Trade Organization meeting, and an early version of our
thinking was launched there by the International Forum on
Globalization. The book is being published when there is a full-
blown debate about obesity and the cost of health care associated
with it. Back in 1999, the UN system’s World Health Organization
prepared a draft strategy on tackling the epidemic of diet-related
disease sweeping our world, which received a hostile reaction
from sections of the food industry. We had realized that, in the
very welcome and rising debate about globalization, the vital
area of food and public health was somehow being marginalized
or perceived as being limited to a few issues such as food safety
and GM foods for example. As we show in this book, food and
health issues go far wider than that, and include large issues such
as the health impact of the spread of Western diets to the develop-
ing world.
While environmentalists and citizens groups had well-
developed debates underway about the cultural and political
transition (and about the need to reform government and policies
in the pursuit of the public, not just the corporate, interest), the
food and public health movement appeared to have been left
on the sidelines – ironically, in the face of the evidence supplied
by epidemiologists and nutritionists arguing for policy change.
We decided that we had to set down our arguments and thoughts.
The process took longer than we expected, as it required us to
enter areas and review data which are themselves immensely
complex and require labyrinthine understanding. The book
underwent an iterative process of being written, read by special-
ists and friends, criticized, wholly rewritten and round again.
We therefore want to pay tribute to our many friends and
colleagues who have encouraged and helped us in this process.
It began for both of us on two fronts. First, from involvement in
XIV ACKNOWLEDGEMENTS

the public policy debate throughout the 1990s, in the course of

which a coalition of interests came together to monitor, engage
with and lobby on the arcane area of international trade regimes
and regulations. Second, we were both involved in following the
global food industry as it struggled to integrate a ‘health’ agenda
into its new product development and marketing strategies.
We felt that health had to be a significant feature in the re-
alignment of food with society. Yet if a good understanding of
food and health issues was poorly represented outside the
decision-making process, discussion about their relevance would
inevitably, it seemed, be left to officials or the industrial interests
about which we were nervous. Our view was that a central role
for food and public health policy was a critical test for sound
policy-making which should be based on best evidence and best
practice.
We have been privileged to be part of that growing debate
and of our own self-education process. So our first debt is to all
those who, over the last 12 years or more, have been prepared to
discuss issues, respond to ideas, ask us to write and present
papers, support as well as curtail our enthusiasms, point out
errors, and do all such helpful things that friends and colleagues
do.
We therefore pay heartfelt tribute, for helping to form the ideas
and thinking in this book, to the following: Annie Anderson, John
Ashton, Carlos Alvarez-Dardet, David Barling, Fran Baum,
Robert Beaglehole, Warren Bell, David Buffin, Colin Butler,
Geoffrey Cannon, Martin Caraher, Mickey Chopra, Charlie
Clutterbuck, John Connor, Dick Copeman, John Coveney,
Michael Crawford, John Cubbin, George Davey-Smith, Barbara
Dinham, Liz Dowler, Anna Ferro-Luzzi, Ben Fine, Ken Fox,
Yiannis Gabriel, Susan George, Edward Goldsmith, C Gopalan,
Jeya Henry, Brian Halweil, Spencer Henson, Ildefonso
Hernández, Nick Hildyard, Colin Hines, Vicki Hird, Dinghua
Hu, Mika Iba, Michael Jacobsen, Phil James, Jean James, Jørgen
Højmark Jensen, Marco Jermini, Andy Jones, Ingrid Keller, Cecile
Knai, Mustafa Koc, Al Krebs, Lyndon Kurth, Ron Labonte,
Felicity Lawrence, Mark Lawrence, Kelley Lee, Rod Leonard, Tim
Lobstein, Jeanette Longfield, David Ludwig, Jerry Mander, John
Manoocheri, Barrie Margetts, Karen McColl, Martin McKee, Tony
McMichael, Philip McMichael, Margaret Mellon, Erik Millstone,
Sid Mintz, Monica Moore, Marion Nestle, Chizuru Nishida,
 ACKNOWLEDGEMENTS XV

Aleck Ostry, Roland Petchey, Miquel Porta, David Porter, Barry

Popkin, Kaisa Poutanen, Jules Pretty, Bill Pritchard, Pekka Puska,
Geof Rayner, Mike Rayner, Tom Reardon, Michael Redclift,
Sarojini Rengam, Neville Rigby, Mark Ritchie, Aileen Robertson,
Peter Rosset, Sam Selikowitz, Aubrey Sheiham, Prakash Shetty,
Mira Shiva, Vandana Shiva, Bruce Silverglade, Boyd Swinburn,
Steve Suppan, Geoff Tansey, David Thomas, Peter Timmer,
Antonia Trichopoulou, Colin Tudge, Flavio Luiz Schieck Valente,
Bill Vorley, Lori Wallach, David Wallinga, Kevin Watkins, Amalia
Waxman, Julius Weinberg, John Wilkinson, Martin Wiseman,
Derek Yach, Taka Yagi, and Richard Young, and all those in the
international food industries and agencies who shared their
insights and thoughts over the years about the business side of
health. All have provided us with encouragement, thoughts,
criticism and advice on the complex range of issues that we
feature in this book.
For permission to use data reproduced in this book, we thank
the World Cancer Research Fund, the ACC-SCN Expert Com-
mittee and Barry Popkin; as ever, all three were inspirations. For
permission to quote work, we thank Rita Clifton of Interbrand,
and the BHF Health Promotion Research Group at Oxford
University.
Many people helped us with the laborious practical process
that is book writing. From 1998 to 2000 Heena Vithlani, Jenny
Lord and Kelly Andrews took turns as PAs to Tim Lang; in 1999,
Pirkko Heasman and Jillian Pitt gave invaluable help on
mapping for us the nutritional and public health aspects of the
globalization of diet; and in 2002, Yannick Borin and Sylvie
Fritche, our inestimable French duo, gave wonderful help with
data-gathering, sorting and tables.
We want also to thank the many people who have commented
on ideas we presented when teaching or at seminars in Australia,
Brazil, Canada, Croatia, Denmark, Finland, India, Italy, Japan,
Kenya, Korea, Latvia, Mexico, The Netherlands, New Zealand,
Russia, Slovenia, Spain, Sweden, Switzerland, the UK and the US
over the last ten years. There have been moments when it has
seemed that there is nowhere we will not go to research food
supply. Our energy-burning, carbon-burning environmental
‘credits’ have no doubt been all used up, as we jetted about, at
other people’s expense, to meetings and conferences where we
could explore, observe and pronounce on the world’s changing
XVI ACKNOWLEDGEMENTS

supply chain. At those many meetings, we would try out many

of the ideas and data given in this book. We are truly grateful to
those who came to discuss with us and give feedback; we hope
they think their efforts were worthwhile.
We also want to thank the many organizations who nurtured
our thoughts, including friends and colleagues at the Inter-
national Forum on Globalization, Pesticides Action Network,
Sustain (created by the merger of the National Food Alliance and
the Sustainable Agriculture, Food and Environment Alliance),
the UK Public Health Association, the Journal of Epidemiology
and Public Health, the Food and Agriculture Organization and
the World Health Organization, all of whom have encouraged
our work over the last decade or so. It would have been much
harder critically to assess the impact of huge societal shifts of
food, the supply chain and health without their support and
encouragement.
Finally, we want to thank Pirkko Heasman and Liz Castledine
for their unstinting support while we wrote this book; Akan
Leander, Angela Cairns and the team at Earthscan and James &
James for producing it; and especially Jonathan Sinclair Wilson
for encouraging us to write it. Any errors and confusions are, of
course, our own.

Tim Lang Michael Heasman

London UK Jokela, Finland
March 2004 March 2004
 LIST OF ACRONYMS AND
ABBREVIATIONS
AoA Agreement on Agriculture (of the GATT)
BMI body mass index
BSE bovine spongiform encephalopathy
BST bovine somatotrophin
CAP Common Agricultural Policy
CEC Commission of the European Community (also EC)
CHD coronary heart disease
CI Consumers International (world body of consumer NGOs)
Codex Codex Alimentarius Commission (joint WHO/FAO body)
CVD cardiovascular disease
DALY disability adjusted life year
EAGGF European Agricultural Guidance and Guarantee Fund (CAP)
EC European Commission
EP European Parliament
EU European Union
FAO Food and Agriculture Organization (of the UN)
GATT General Agreement on Tariffs and Trade
GBD Global Burden of Disease (a research study)
GM genetic modification
IARC International Agency for Research on Cancer
ICN International Conference on Nutrition (1992)
IFG International Forum on Globalization
IFPRI International Food Policy Research Institute
JECFA Joint Expert Committee on Food Additives
NGO non-governmental organization
NIDDM non-insulin-dependent diabetes mellitus
OECD Organisation for Economic Co-operation and Development
PCB polychlorinated biphenyl
POPs persistent organic pollutants
SFS Surplus Food Scheme
SME small- or medium-sized enterprise
SPS Sanitary and Phytosanitary Standards (part of 1994 GATT)
TBT Technical Barriers to Trade (part of the 1994 GATT)
TNCs transnational corporations
UN United Nations
UNCED United Nations Conference on Environment and
Development (1992) (also known as the Earth Summit)
UNEP United Nations Environment Programme
WFS World Food Summit (1996)
WHO World Health Organization (of the United Nations)
WHO-E World Health Organization Regional Office for Europe
WIPO World Intellectual Property Organization
WTO World Trade Organization
‘The history of the world, my sweet, is who gets
eaten and who gets to eat’
Sweeney Todd

For what can war, but endless war still breed?

Till truth and right from violence be freed,
And public faith clear’d from the shameful brand
Of public fraud. In vain doth Valour bleed,
While Avarice and Rapine share the land.

John Milton, English poet, 1608–1674;

from To the Lord General Fairfax (1648)
 INTRODUCTION 1

INTRODUCTION
‘Freedom from want of food, therefore, must mean making available for
every citizen in every country sufficient of the right kind of food for health.
If we are planning food for the people, no lower standard can be accepted.’

Sir John Boyd Orr, first Director-General of the Food and

Agriculture Organization of the United Nations (1880–1971)1

CORE ARGUMENTS
Food policy is in crisis, in particular over health. Yet health
can be the key to the solution to this crisis. For the last
half-century, there has been one dominant model of food
supply. This is now running out of steam and is being chal-
lenged by competing approaches: three major scenarios,
each of which is shaping the future of food and health. We
argue that, at the heart of any new vision, there has to be a
coherent conception of how to link human with ecological
health. Humanity has reached a critical juncture in its
relationship to food supply and food policy, and both
public and corporate policies are failing to grasp the enorm-
ity of the challenge. Food policy needs to provide solutions
to the worldwide burden of disease, ill health and food-
related environmental damage. There is a new era of
experimentation underway emerging out of the decades
we term the ‘Food Wars’. These have been characterized
by struggles over how to conceive of the future of food and
the shaping of minds, markets and mouths.

Food is an intimate part of our daily lives. It is a biological neces-

sity but it also shapes and is a vehicle for the way we interact with
2 FOOD WARS

friends, family, work colleagues and ourselves. It is associated

with pleasure, seduction, pain, power and caring. As we eat our
daily food, bought in the shops that we know, buying brands that
we are familiar with, it is hard to imagine that there is such a thing
as a global food economy, stretching from the local corner store
to the giant food conglomerate, under pressure right from the
way food is produced and processed to its impact on our long-
term health and well-being.
Our interest here is in food policy: the decision-making that
shapes the way the world of food operates and is controlled. We
see the world of food policy as formed and fractured by a series
of conflicts – the Food Wars – structured around three dominant
worldviews or ‘paradigms’ (a term explained fully in Chapter 1).
These offer different conceptions of the relationship between
food and health and also offer distinct and sometimes competing
choices for public policy, the corporate sector and civil society. We
argue that health has often been somewhat marginalized in
policy and that the Food Wars are, in part, about a jostling for
position by different interest groups seeking to influence the
future of food.
Addressing the challenges of health will require better pro-
cesses for making food policies and reform of the institutions of
food governance; they need to be shaped in an integrated way.
Unless this is done, we believe that the food supply chain will
lose public trust. If it is to achieve popular support and legiti-
macy, it will need to be infused with what we call ‘food demo-
cracy’, a notion we explore towards the end of the book.
Our focus therefore is on the policy choices that shape how
humanity orders its food economy and on urging public policy
to play a positive role in promoting the public good. To this end,
we explore five key elements of the world of food that we con-
sider to be crucial. These are:

l health: the relationships between diet, disease, nutrition and

public health;
l business: the way food is produced and handled, from farm
inputs to consumption;
l consumer culture: how, why and where people consume
food;
l the environment: the use and misuse of land, sea and other
natural resources when producing food; and
 INTRODUCTION 3

l food governance: how the food economy is regulated and how

food policy choices are made and implemented.

These issues are often studied in isolation, and at times deserve

such micro-attention. But the scale of the pressures and chal-
lenges in the context of the global food supply now suggests that
this ‘compartmental’ approach is no longer a viable way of
handling food policy-making. We are calling for a new frame-
work for making food policy choices.
While today’s food economy is grounded in a long history of
production, experimentation and technological change, the
industrial food supply is still relatively young in human history
– a little more than 150 to 200 years old. Since World War II the
food economy has undergone further remarkable commercial
and technological expansion in order to provide food for an
unprecedented growth in human population to more than
6 billion in 2003, and can deliver, in theory, enough food to end
world hunger. For those with the means and access to purchase
them, the modern food system has produced an array of proces-
sed, all-year-round, convenient foodstuffs never before available.
Yet at this very pinnacle of success in the way food is produced,
the sustainability of food production systems and the quality of
foodstuffs in the developed and developing worlds are being
challenged as never before. The current food system appears to
lurch from crisis to crisis: from new health scares such as BSE to
environmental disasters such as over-fishing and the collapse of
fish stocks. At the same time, global food supply faces new
challenges: a continuing surge in population growth in some
parts of the world and an increasingly aged population in others;
the introduction of radical new technologies such as genetic
modification; a new global scale and scope of corporate control
and influence; a breakdown in consumer trust in food govern-
ance and institutions; and persistent health problems associated
with inadequate diet such as heart disease, obesity and diabetes
which, alongside hunger and famine, affect hundreds of millions
of people.
It is obvious that something has to be done for the future. Food
Wars argues that such challenges cannot be met in a piecemeal
fashion. There has to be a new vision of public health. Our concern
is to make the links across these discrete policy areas and to show
continuity in thinking, from the way food is produced to the
4 FOOD WARS

management of consumption and the healthiness of foodstuffs.

We argue that the future viability of the food economy can be
framed to deliver effectively to the general public only if there are
new and integrated policy choices.
Difficult questions loom. How can population health goals be
reconciled with the way people want to live their lives? Can
consumers realistically continue to expect ever cheaper food?
What sort of intensification in production is best for human and
environmental health? How can patterns of food trade benefit
more people? What are the acceptable limits to the continuing
concentration of market share by giant food companies? To what
extent should public money support food production, if at all?

WHY FOOD WARS?

Every day, millions of men, women and children are direct or
indirect casualties of failures of food policy to deliver safe,
nutritious and life-enhancing diets. People raised in the devel-
oped world since World War II may think that the damage is felt
only in areas of the world that suffer famine, malnutrition or
other deficiencies; but in the rich world too there is a huge toll.
While Western societies have increased the caloric content of the
diet and boosted the sheer quantity of our food, they have at the
same time introduced methods of production, distribution and
consumption that threaten the future of the food system that
delivers those calories. These methods have at the same time
contributed to reducing the quality and nutritional value of many
foodstuffs (such as the loss of essential bioactive components like
vitamins and minerals). Health has been assumed to follow from
sufficiency of supply. While scientific understanding of food is
now very complex, too much policy-making has failed to face up
to the human and environmental health damage that surrounds
it.
All around us, food culture is divided. On the one hand, we
have ‘celebrity chefs’ with top-rating TV shows, cookery and diet
books on the best-seller lists, and popular media concerns about
food quality, safety and availability. On the other hand, a crisis
of food supply still dominates great tracts of the world. Hunger
and under-nutrition still dog many lands, as well as premature
deaths due to malconsumption and over-consumption. In 2001,
 INTRODUCTION 5

for example, the US Surgeon General attributed 300,000

deaths in the US alone to obesity.2 This book is partly about these
dichotomies: over- and under-consumption; over- and under-
production; over- and under-availability; intensification versus
extensification; and hi-tech solutions versus traditional, cultur-
ally based ones.
In the Food Wars, there are numerous conflicts over the qual-
ity of food; food safety; nutrition; trade in foodstuffs; corporate
control of food supply; food poverty and supply insecurity; the
coexistence of the overfed and underfed; the unprecedented
environmental damage from food production and the role and
purpose of technology. How are organizations, policy-makers,
businesses, farmers, non-governmental organizations (NGOs)
and even individuals to tackle the enormity of the global and
local challenges now confronting the food system? Despite appa-
rent food abundance, the security of the food supply cannot be
taken for granted.
We set out to write this book because we were frustrated that
the key figures in food policy appeared to be skirting around
major problems rather than facing them, or too often dealing
with the challenges separately in neat policy boxes rather than
holistically. Much of the food industry sees the responsibility for
food as lying with the individual consumer, and any ‘liberal’-
minded intervention in food supply, they argue, is condescend-
ing: treating individuals as victims rather than intelligent food
consumers. Such an approach, we argue, ignores the realities and
the scale of the crisis in food and health which is beyond the
scope of either individuals or single companies, and also ignores
the power relationships shaping food supply. Much of this book
is our attempt to resolve the complex battles over what the ‘food
and health’ problem really is and what to do about it.

ARE RADICAL OPTIONS IN FOOD AND

HEALTH FEASIBLE OR EVEN POSSIBLE?
Within the world of food policy there is a creeping recognition
that radical solutions are needed. Distinct policy choices are
emerging which will frame business and consumer opportuni-
ties. In the nutrition sciences, for example, a new ‘ecological
6 FOOD WARS

nutrition’ is being developed along evolutionary principles –

seeking diets that suit humans’ evolutionary legacy. Such think-
ing has the potential to offer new radical ways of perceiving food
and health (in particular the way food is produced) that go
beyond the narrow ‘technical fix’ of many solutions being offered
to ‘feed the world’ or to maintain health and fitness in ageing
consumers in the developed world through ‘health-enhancing’
foods and beverages. Another big factor is the apparent revolu-
tion in ‘life sciences’, based upon an understanding that genes
predispose people to diseases and that diet may trigger genetic
predispositions. This so-called nutrigenomic understanding
could have profound implications for the ‘personalization’ or
‘individualization’ of diets.
The word ‘radical’ is used here in the way that world business
expert Gary Hamel uses it, namely that a ‘radical idea has the
power to change customer expectations. . . to change the basis for
competition. . . and the power to change industry economics.’3
We argue that beneath the apparently calm surface of the food
supply chain (which, for all its scandals and monetary crises, has
increased output and fed more people than ever before in human
history) there are powerful undercurrents. Consumers appear,
for example, to be able to change what they demand from the
supply chain in fundamental ways; the recent restructuring of the
food economy is changing the basis for competition and what is
meant by a ‘market’; and globalizing influences are changing the
industry.
A prominent example of radical thinking entering the food
industry is the way in which nutrition science is currently being
used for new product development, food marketing and
business strategy. In 2003 the Chief Executive Officer of Nestlé,
the planet’s largest food company, for example, stated that Nestlé
aimed to become the world’s leading nutrition company within
five years.4 This announced what, in effect, we are starting to
recognize: that no food company can remain in business today
without creating added value through nutrition and health. Yet
where is there a similar vision for food, nutrition and health in
public policy? What should such a vision look like? What should
it include or exclude? How can it embrace the whole food chain,
from growing food to final consumption?
Another radical conflict, in a polarized form, can be seen in
the global tussle between a ‘GM’ (genetically modified) future or
 INTRODUCTION 7

an ‘organic’ future – with both camps making claims of enhanced

health benefits as the rationale for their competing ways of
producing food. Through examples such as these we try, where
possible, to explore the possibility of ‘radical’ options in food and
health policy and whether these are feasible, what their scope
might be, or even whether the ‘technical fix’ approach is the most
appropriate way forward.
The foundation on which we build our call for a more radical
approach to how food is grown and produced is the following:

l The model of food and agriculture put in place in the mid-

20th century has been very successful in raising output but it
has put quantity before quality.
l Humanity has moved from an agricultural/rural to a hyper-
market/urban food culture in a remarkably short time, a
process beginning to roll out fast in the developing world at
present.
l While policy attention has traditionally been on agriculture,
it is what happens off the farm in terms of processing, retail
and food service that is in effect changing the food economy,
not least for the labour force which can too often suffer low
wages and poor conditions.
l Throughout the world, diet is changing in ways that carry
huge health implications and challenges. This is in part due to
trade liberalization and in part to consumer aspirations; in this
respect, there is both a ‘push’ and a ‘pull’ in the food system.
l Food, nutrition and health challenges are global. Countries
like Brazil, India and China are already in the grip of a double
burden of food-related disease: degenerative diseases (heart
disease, cancers, diabetes and obesity) take a heavy toll in all
countries. At the same time mass hunger persists.
l An individualized medical model of food and nutrition is
predominant and is presented as the only source of appropri-
ate solutions to food and health challenges.
l The environmental pressures on food production are reach-
ing crisis scale, from over-fishing (a reality facing Canada and
the European Union), through the loss of soil to grow food in,
to not enough water for agricultural production and irrigation.
l Without an ecologically integrated perspective, food policy
will remain unable to provide long-term consumer confid-
ence or food supply and distribution security.
8 FOOD WARS

l There is rising evidence of injustice within the food system.

This includes the maldistribution of food, poor access to a
good diet, inequities in the labour process and unfair returns
for key suppliers along the food chain.

AN OUTLINE OF THE BOOK

This is a book about ideas of how the future of food is to be
shaped and conceived. We address this task by setting up a
conceptual framework in Chapter 1 of three paradigms. There we
discuss in detail the character of the Food Wars, the assumptions
of the paradigms that inform this book and what we mean by a
paradigm. We argue that food policy often has a troubled rela-
tionship with evidence – sometimes lagging, sometimes leading
it. How much evidence is needed to change policy?
Chapters 2 to 7 deal in detail with the evidence in support of
our conceptual framework as it relates to health, food policy and
the dynamics of the food system. We start by looking at the
evidence of how the world’s diet is changing and facing the
problems of both under-consumption and over-consumption,
often within the same countries. There is the mythology that the
rich world suffers heart disease while the poor world suffers
hunger. Diet-related diseases such as heart disease are becoming
rapidly more prevalent in low- and medium-income countries.
We show how diet- and health-related problems are growing in
scale, not diminishing, as might be assumed with better food
supply. Newer concerns such as obesity and diabetes are rising,
in addition to the ongoing costs of heart disease.
In Chapter 3 we look at how public policy has responded to
evidence about diet and disease. We give a short historical over-
view of changing conceptions of public health and the import-
ance of nutrition, arguing that nutrition is a battleground be-
tween those who see it as framed by social objectives and those
who believe that targeting only ‘at risk’ individuals is a more
effective intervention. We review how governments have tended
to rely upon health education as the mechanism for improving
public health, setting dietary goals and offering guidelines which
put responsibility upon individuals for their own health. We
question this food policy strategy.
The success or failure of food policy will be dependent on
how it relates to the workings of the food economy and affects
 INTRODUCTION 9

particular food business interests. In Chapter 4 we present an

overview of what is meant by the food system/economy, arguing
that, while consolidation and concentration of the power of the
food industry is a long-running trend, the scale and pace of this
change are new. The food industry is relying on a twin strategy
to take it into the future: first, relying on technology and ‘tech-
nical fixes’ to resolve most problems; and second, aligning itself
with the interests of consumers.
While most food companies today will describe themselves
and their activities as ‘consumer-led’, we argue that such an
epithet is too superficial. We propose that a better grasp of food
and consumer culture would help public policy analysts face
what is happening in modern food markets. In Chapter 5 we map
out what we see as the new consumer culture and landscape.
Even at the basic market-led level, the rich-world consumer is
developing a very different conception of food: convenience,
snacking, ready meals, an eating-out culture and a food lifestyle
that meet time constraints, and that recognize the newer role of
women in society.
Chapter 6 turns to another war zone: essentially a conflict
over food quality. Our case is that the food supply chain is com-
mitted to producing a range of foodstuffs in environmentally
unsustainable and wasteful ways that militate against human
health. Today’s food supply chain, while seemingly appropriate
for the past, is now shown to damage and threaten the environ-
ment. Food, a means for life, is threatening its own continued
production. Too many policy-makers still believe that they can
merely ‘bolt on’ an eco-friendly niche market to the crisis of food
and the environment. A re-orientation of the entire food supply
chain is needed if both human and environmental health are to
be delivered.
In the commercial context, there is no respite in the tragedies
continually hitting rural and farming communities. While farm-
ers and the land are being squeezed, oligopolies from agribusi-
ness to food processing, retailing and even food service dictate
the workings of the food supply chain. We suggest that much
public policy response to date has been at best reactive rather
than proactive; and in many instances, NGOs and the business
and scientific communities, albeit differently, have been more in
tune with wider societal trends about food and health than
policy-makers and government. But, as we argue in Chapter 7,
future food and health choices must ultimately be resolved in
10 FOOD WARS

public discourse: designing and reworking the institutional

‘architecture’ of food policy to deliver public goods is a pressing
challenge. There are limited public forums for delivering, let
alone creating, an integrated food and health policy. There is a
crisis of institutions and of governance (that curious English
word that refers to the science and practice of government) at all
levels – local, national, regional and global. The processes of
government are too often trapped in ‘boxes’ of responsibility,
with no one retaining overall responsibility across the different
compartments.
Our objective in this book is to contribute to the debate and
to suggest that there is already available a wide range of policy
options and alternative voices. In Chapter 8 we argue that policy-
makers too often assume that they have little choice and con-
sequently discourage the alternatives. But we think that there is
a new era of experimentation underway and through our ‘para-
digms’ we show that there are different ways of assessing and
making choices.
A new conception of health – linking human and ecological
health – has to be at the heart of a new policy vision. To deliver
healthy consumption requires a different set of priorities within
the food supply chain. We need to generate new areas of know-
ledge about food and health. Food policy in general needs to
develop a range of alternative food scenarios, at the very least as
‘insurance policies’ against unforeseen crises and to tackle the
unacceptable legacy from the last century of disease, ill health
and environmental damage.
This book offers a panorama. We argue that throughout the
20th century, food caused problems in public and corporate
policy and, vice versa, public and corporate policy caused
problems for the world of food. Numerous crises have sparked
incremental reforms, most recently over food safety. But still,
the framework of public policy on food is too fragmented and
restricted. Problems are addressed too often in an ad hoc or
interim manner when what is required is a systematic framework
for addressing food policy, integrating core drivers such as
health, business, environmental impact, consumer experience
and policy management. This more coordinated approach may
still be in embryonic stages but it already finds itself in an arena
of considerable conflict. There is some way to go in the Food Wars
before there is Food Peace.
 THE FOOD WARS THESIS 11

CHAPTER 1
THE FOOD WARS THESIS
‘If you know before you look, you cannot see for knowing.’

Sir Terry Frost RA (British artist 1915–2003)

CORE ARGUMENTS
Different visions for the future of food are shaping the
potential for how food will be produced and marketed.
Inevitably, there will be policy choices – for the state, the
corporate sector and civil society. Human and environ-
mental health needs to be at the heart of these choices.
Three broad conceptual frameworks or ‘paradigms’ pro-
pose the way forward for food policy, the food economy
and health itself. All make claims to raise production and
to deliver health benefits through food. The challenge for
policy-makers is how to sift through the evidence and to
give a fair hearing to a range of choices. This process is
sometimes difficult because the relationship between evid-
ence and policy is not what it seems. The world of food is
on the cusp of a far-reaching transition.

INTRODUCTION
The world is producing more food than ever to feed more mouths
than ever.1 For the better off there are more food and beverage
product choices than it is possible to imagine – globally 25,000
products in the average supermarket and more than 20,000 new
packaged foods and beverages in 2002 alone.2 Yet for many
people there is a general feeling of unease and mistrust about the
12 FOOD WARS

future of our food supply. Food and problems associated with

producing and consuming food generate political and policy
crises and are regular fodder for media coverage. In addition,
along with the food production successes of the past 40 years in
reducing famine, hunger continues hand in hand with excess.
The optimism of the 20th-century food policy planners that, with
good management and science problems associated with food
would disappear, has not been fulfilled. Food’s capacity to cause
problems has not lessened.
As we will show, new relationships are already apparent
throughout the entire food supply chain, from the way the food
is produced to its consumption. Increasingly, alternatives to the
prevailing structures of the food economy are also being widely
mooted. No wonder there are such arguments about food. The
pace and scale of change engender reactions; forces within the
food supply chain are often at odds with each other about their
vision for the future; there are competing versions of what the
future could be, over which partisan forces argue. Our simple
conclusion is that food policy-making matters more now than
ever before.
To set the context for the future of food policy over the next
two decades, we see the world of food supply currently in the
throes of a long-term transition: from a food policy world domin-
ated by farming and agriculture, agribusiness and commodity-
style production, to one dominated by consumption: major
branded food manufacturers, food retailing and food service.
This transition is causing new tensions, challenges, threats and
opportunities along the whole food chain, from farm to consumer,
which we call the Food Wars: the precursor to what we argue is a
fundamental reframing of the assumptions about the way we will
come to analyse, research and carry out food production, the
Food Wars encompass competing visions and models for the
future of food supply driven, in part, by emerging new scientific
understanding and accompanying technologies, but also by food
politics and shifting demographics in terms of patterns of diet-
related disease and illness as well as consumer-lifestyle choices.
In this chapter we set out to capture this complex pattern of
change by suggesting a new conceptual model of three compet-
ing frameworks or ‘paradigms’ for food which we term the
Productionist paradigm (the dominant and current model), the
newly emerging Life Sciences Integrated paradigm and the
 THE FOOD WARS THESIS 13

Ecologically Integrated paradigm. But first we need to set out

some basic assumptions about food policy and the food supply
chain that informs this conceptual model.

FOOD POLICY CHOICES

Throughout this book, we use the terms ‘food and health policy’,
‘food policy’ and ‘food and farming policy’: those policies and the
policy-making processes that shape the outcome of the food
supply chain, food culture and who eats what, when and how,
and with what consequences. Our task here is to unravel the
strands of competing interests and policy objectives. There is no
one food policy or one food policy-maker: there are policies and
policy-makers, all of which contribute to the overall process.
Food policy-making is essentially a social process. The shape
of the food supply chain is the outcome of myriad decisions and
actions from production to consumption; it can involve people
and organizations who may not even call themselves policy-
makers. For example, the food industry, when it sets specifica-
tions for food products, is in part determining the nutritional
intake of consumers; health-care planners, when facing the
burgeoning costs of managing the rise of certain diseases (such
as diabetes and some cancers) are making decisions that are
‘policy’, dealing with the results of how food is produced and
consumed. Equally, competition authorities or town planners,
when making decisions about retail market share or the siting of
supermarkets, are determining issues as diverse as prices, access
to food shops and local culture. The value of this very broad
conception of food policy is that it helps to make sense of what
otherwise remains a disparate, inchoate jumble.
Food policy is contested terrain: a battle of interests, know-
ledge and beliefs. The sort of food economy that exists is the
result of a set of conscious policy choices made in the past,
including both state and corporate decisions, involving funding
for particular types of food production and processing, the
setting of research priorities and national and strategic objectives,
the provision of education and information, the creation of rules
for trade and safe food and law enforcement and sanctions when
things go wrong.
14 FOOD WARS

Our conception of food policy is that it should embrace

decision-making along the whole of what is known as the food
supply chain. Figure 1.1 is a simplified version of what is meant
by the food system3 or food supply chain – a term originally
promoted by agricultural economists who now use a different
term – ‘value chain’ – to analyse how, from farm to consumer, raw
commodities get value added to them. The important point to
note is that analysis from a food-chain perspective assumes that
change in one part of the chain, intentionally or not, has an
impact on other parts. Increasingly, analysis from a food-chain
perspective is used to understand trends and the global restruc-
turing of the food supply.

Supply of Agricultural Inputs

eg fertilizers, pesticides, vet drugs, GMO seeds

Primary Production
eg farmers, fisherman, fish farmers

Primary Food Processing

eg on-farm, dairies, abattoirs, grain mills

Secondary Food Processing

eg canning, freezing, drying, brewing

Food Distribution
eg national/international, import/export

Food retailing Food Catering

eg supermarkets, shops eg restaurants, hospitals, schools

Domestic Food

Source: WHO

Figure 1.1 A simple version of the food supply chain

 THE FOOD WARS THESIS 15

KEY CHARACTERISTICS OF THE

FOOD SUPPLY CHAIN
The model of the food supply chain in Figure 1.1 allows us to note
some key characteristics of the modern supply system. We can
summarize these under four main arguments:

Pressures ‘off the farm’ dominate the food system

Traditionally, for the last century, agriculture has dominated food

policy thinking and still dominates international budgetary
debates (for instance about the rights and wrongs of subsidies).
The food supply chain is today driven by forces away from the
farm, yet policy still focuses on commodity-producing agricul-
ture. Pressures off the land are more important in framing the
food economy than politicians often like to admit. Today, the
main drivers of the food supply chain are the powerful forces of
processors, traders and retailers, in turn focusing on capturing
consumer needs.

Consumption is the key to understanding the food

system

Power in the modern food economy is increasingly driven by

concerns about the consumption end of the food supply chain.
With the rise to dominance of food retailing, the retailer is a
broker – between primary producers and consumption – and is
a powerful figure in the corridors of power. Yet individual retail
consumers are diverse and usually unconscious of their collective
influence: they can be badly organized and they carry most of the
health costs of current food supply, yet they are made responsible
for their own diet-related (ill) health since they are ultimately
answerable for what they eat – put another way, food production
is being posited as a victim of consumer choice!

Public and corporate interests do not correspond

The pace of development and the structure of the food chain is

being increasingly shaped by a small number of powerful food
16 FOOD WARS

conglomerates. While this has been an evolving process, con-

solidation in the food industry has now reached a new level of
influence in key markets. These corporate interests see food
policy-making as part of their business strategy and are often
well represented in the food policy arenas. This can be double-
edged: on one hand, industry interests are frequently more aware
of public objectives and unhappiness than the supposed public
guardians themselves, and on the other hand, industry is hardly
likely to give due weight to policy that conflicts with its immedi-
ate financial and market positioning. This raises a problem for
what we call food governance – the role of public democratic
control, accountability and public responsibility – an issue raised
throughout this book but particularly addressed in Chapter 7.

Health has been marginalized in the food economy

Although the food supply chain model in Figure 1.1 is a simpli-

fied description of the food economy, it can imply support for the
view that human and environmental health are an outcome of
the smooth running of the food supply chain. In fact, health can
fall down the gaps between sectors and is not seen as a prime
responsibility of any one group. Human and environmental
health ought to be the connecting tissue between and within all
the economic sectors and be intrinsic to the whole food supply
chain. A valuable debate has begun from an environmental
health perspective; there now needs to be debate beginning from
a human health perspective.

THE WAR OF PARADIGMS: TIME FOR A

NEW FRAMEWORK?
There are structural tensions between different interests, views
and economic investment patterns in food policy which are far-
reaching in their consequences. Despite many illusions to the
contrary, there is in the real world of food politics much jostling
for position and attempts to impose rules on others. Our concern
here is that the outcome of these conflicts and the compromises
that are hammered out in policy meetings constantly shape the
food supply chain. The overriding framework of food policy in
 THE FOOD WARS THESIS 17

relation to health, humanity and society as a whole requires

major re-working. It is the whole picture that is our concern.
The choices that we explore in this book can perhaps best be
understood in three ways: first, there are a number of key battle-
grounds in the Food Wars; second, the outcome of these global
conflicts is of immense significance for human health, that is, of
individuals, societies and environment, ie ecological health;
third, new ways of thinking about the future of food suggest that
a paradigm shift is underway.
If a paradigm is a set of assumptions from which new know-
ledge is generated, a way of seeing the world which shapes
intellectual beliefs and actions, then science is a process, not an
endgame of neutral fact-finding; it expresses values even in its
facts. We use the term ‘food paradigm’ to indicate a set of shared
understandings, common rules and ways of conceiving problems
and solutions about food. A paradigm for us is an underlying,
fundamental set of framing assumptions that shape the way a
body of knowledge is thought of.
The term ‘paradigm’ is associated with the work of Thomas
Kuhn, the philosopher of science who first popularized the term.4
In fact, he merely built on a concept spelled out by Ludwig
Wittgenstein (1889–1951), the Austrian philosopher. Kuhn took
Wittgenstein’s concept of paradigms and applied it to science as
a process of making ideas: a set of ‘universally recognised scien-
tific achievements that for a time provide model problems and
solutions to a community of practitioners’. Kuhn was interested
in how scientific understanding went through momentous crisis
points and what determined why one accepted framework of
thinking fell by the wayside while another triumphed in its place.
(For example, the work of Isaac Newton transformed how humans
thought of the physical world; nearly three centuries later the
new physics of relativity which Albert Einstein and others intro-
duced created another paradigm shift which replaced the New-
tonian worldview, transforming and superseding its tenets.)
Kuhn himself was said to have used the term with at least 21
different shades of meaning,5 and academics today use the term
‘paradigm’ more fluidly or metaphorically than even Kuhn
originally intended.
The food system that developed rapidly after World War II
exemplified a way of thinking that we call the Productionist
paradigm: it remains the dominant worldview, but one which is
18 FOOD WARS

now contested in respect of the future of food by newer ‘models’,

chief amongst which are two emerging frameworks, which we
call the Life Sciences Integrated paradigm and the Ecologically
Integrated paradigm. Both are grounded in the science of biology,
but each interprets biological and societal systems in ways that
offer differing choices for our food future: how food is produced,
who produces it and how it is sold; questions of social justice,
where the food is produced (global versus local sourcing) and the
place of food in human health. Figure 1.2 illustrates how we see
the situation in the era of the Food Wars.

Agricultural
Revolution

Life Sciences Integrated

Paradigm
Industrializ-
ation of
Food

Productionist
Food
Paradigm Wars
Chemical
Revolution

Ecologically Integrated
Paradigm
Transport
Revolution

1800s 1900s 1950 2000 2050

LEGEND:
= Key battlegrounds in the Food Wars. These include:
• Diet, health and disease prevention
• Environmental crisis
• Capturing the consumer
• Controlling food supply
• What sort of food business
• Competing visions and ideologies

Figure 1.2 The era of the Food Wars

THE PRODUCTIONIST PARADIGM

Very powerful forces are lining up behind these new paradigms
for food – but it should be realized that the existing Productionist
paradigm still has influence – as is evidenced, for example, by the
continued failure to fundamentally reform the European Union’s
Common Agricultural Policy. We argue that the status quo is no
 THE FOOD WARS THESIS 19

longer a viable option because the very methods it uses, such as

animal husbandry, chemical inputs and its patterns of trade, are
making it a poor policy option, no longer serving the public
interest. We see the assumptions of this paradigm being chal-
lenged on many fronts and failing in credibility in significant
areas.
The origins of the Productionist paradigm lie in the indus-
trialization of food over the last 200 years and its concomitant
advances in chemical, transport and agricultural technologies.
Over this period food supply in many parts of the world has
moved from often local, small-scale production to concentrated
production and mass distribution of foodstuffs. Such a shift is a
defining characteristic of the Productionist paradigm (even
though it should be noted that much global food production is
still local or regionally based).
With the arrival of industrialization and the explosion of
urban populations in the last two centuries, social division of
food became even more politically sensitive. Reliance on trade in
food commodities, such as spices and sugar,6 already consider-
able for some foods, grew; pressures to intensify production
accelerated, increasing rural poverty: increased output from the
land reduced the actual labour required on the land. The features
of this agricultural revolution include: the increased use of inputs
and of plant and animal breeding, the growth of fewer but larger
farms, mechanization and a reliance on fossil fuels.7, 8
For us the Productionist paradigm goes far beyond the farm:
it typified the whole 20th-century outlook – in particular from
the 1930s onwards – in which the food supply chain became
production-led in order to increase the quantity of food over other
priorities. It developed a science base to further the goals of
increasing output. Universities, colleges of agriculture, extension
services and a whole panoply of support were gradually incorpo-
rated into this paradigm, which came to dominate food policy
after the shortages and failures of the pre-World War II period.
The production-driven model was built not just upon the agri-
cultural revolution of the 18th century onwards (and of the
chemical and transport revolutions too), but on the capacity of
food processors to preserve, store and distribute food en masse.9
The triumph of the Productionist paradigm was cemented in
the experience of mid-20th century starvation, food shortages,
and maldistribution in many countries.10 Throughout the world,
20 FOOD WARS

governments created new national and international policies

designed to increase production by applying large-scale indus-
trial techniques that applied modern chemical, transportation,
processing and farming technologies. The overarching goal of
this paradigm was to increase output and efficiencies of labour
and capital for increasingly urbanized populations. It is an irony
that, while historically one of its policy goals was to increase
national self-sufficiency and production, its surpluses are now
being used to weaken the self-sufficiency policies of many devel-
oping countries who are being urged to open their local markets
to global trade.
Now, half a century on from the consolidation of the Pro-
ductionist paradigm, it is under strain and showing up major
limitations. Although Productionism has been successful in
raising production in line with an unprecedented rise in world
population, 1.9 to 2.2 billion people in the world are estimated to
remain directly or indirectly untouched by modern agricultural
technology.11 Health and environmental strains are threatening
its survival: matters such as oil shortages, climate change, labour
‘efficiencies’, water depletion, pollution and public concern
about animal welfare and the nature of plant and animal breed-
ing. There is also a serious battle over who owns the food supply,
not just in terms of companies (which we discuss in Chapter 4)
but also of the intellectual property, even the genetic basis, of
foods.12
To achieve its objectives, industrialized production historic-
ally focused on monocultures (single crops in a field) rather than
diversity, but this created a reliance on artificial inputs (pesticides
and fertilizers) and energy-intensive engineering both on and off
the farm. The sustainability and profitability of the Productionist
paradigm is now far from certain, with agribusiness and politics,
as well as markets and consumers, now questioning how our
food is produced.

TWO NEW PARADIGMS OF FOOD SUPPLY?

The limitations of the Productionist paradigm manifest them-
selves in the increasing number of Food Wars over such issues as
the health implications of chemicals used in production and the
 THE FOOD WARS THESIS 21

treatment of animals, through environmental damage and pollu-

tion and global trading practices to corporate control and power
and the mistrust of consumers. But there are two strong alterna-
tive paradigms emerging, and we gather these under two con-
ceptual frameworks: both offer human and environmental health
benefits and both are grounded in new understanding of the
science of biology.
Out of the Food Wars, therefore, we see emerging two poss-
ible science-informed visions for the future. They are competing
paradigms for the future of food, both seeking to transform the
Productionist paradigm. One is what we call the Life Sciences
Integrated paradigm and the other the Ecologically Integrated
paradigm. (Figure 1.2 on page 18 situates both paradigms his-
torically in the context of the Food Wars.) Both derive from a
common root: the argument that the 21st century will be the
century of biology. 13 ‘Bio’ is now the language of innovation
and represents a fundamental shift in the understanding of
life: if the 20th century was characterized by the emergence of
post-industrialization and ‘information’, then the 21st century
promises to be the age of biological science. It is already giving
rise to new controversies, for example over genetically modified
foods and cloning. Languages in many tongues are being forced
to inject new ‘bio’-words into their lexicon: there is now biopro-
cessing, bioprospecting, bioprivacy, bioextinction, biodiversty,
bioscience, bioinformatics, biovigilance, biosafety, bioterrrorism
and, of course, biotechnologies.
In short, the future of the food economy will rely more upon
the biological rather than the chemical sciences to deliver its
vision for production, even though the chemical sciences will
continue to play a prominent role in the medium term. As most
of us know, a critical battle has been waged over the application
of biotechnology to plants designed to resist specific chemical
weed killers. The industrial nature of the Productionist paradigm
is being softened and reshaped by new biological thinking.

THE LIFE SCIENCES INTEGRATED PARADIGM

The Life Sciences Integrated paradigm describes the rapidly
emerging scientific framework that is heralding the application
22 FOOD WARS

of new biological technologies to food production. We propose

this paradigm as a way of capturing a body of thought that has
as its core a mechanistic and fairly medicalized interpretation of
human and environmental health. In this, food is perceived as
almost like a drug, a solution to diseased conditions, part of a
planned, controllable and systemic manipulation of the determi-
nants of health and ill health. This highly sophisticated thinking
about food and health is at the heart of the application of biotech-
nology to food production, and its application on an industrial
scale is at the core of the Life Sciences Integrated paradigm. A
distinguishing characteristic is its reliance on biological rather
than chemical sciences to deliver its vision for production. Tech-
niques in biotechnology are already delivering many advances in
food production methods, food handling and consumer products.
We should stress here that this paradigm means more than
genetic modification (GM) alone, and includes the whole spec-
trum of biotechnology: that is, the use and manipulation of living
materials in the manufacture and processing of foodstuffs. En-
zymes, for example, are a key processing aid within biotech-
nology that receive only negligible publicity or adverse publicity.14
But it is GM that has become the central defining characteristic
of the Life Sciences Integrated paradigm and the focus of media,
consumer, and policy attention. GM seeds and the chemical
inputs they require are reshaping the biological base of agri-
cultural production at a speed that is unprecedented in human
food production. Despite the relatively crude state of the tech-
nology, GM is being introduced into world food systems at a rate
that some see as irreversible. The long-term implications for
agricultural environments, and for the structure and power
relationships in the food chain, are unknown.
The novelty of the science – taking the genes from unrelated
species and inserting them into another to forge a new plant or
animal that would not be possible in nature (known technically
as ‘recombinant DNA biotechnology’) – represents a revolu-
tionary technological shift set to change the economics of whole
industries. One of the attractions of the paradigm is that in many
respects it relies on a simple re-interpretation of the existing
Productionist paradigm but claims to remedy a number of its
limitations: from lessening environmental impacts, through
improving human health from greater food production, to creat-
ing new products with enhanced, yet often contested, health
benefits.
 THE FOOD WARS THESIS 23

From an agricultural point of view, the commercialization of

crops through GM has so far been spectacular and is being
heralded as the new Green Revolution, even though there are
reservations about the technology.15 As a result, the Life Sciences
Integrated paradigm is well placed to become the dominant
paradigm of the early 21st century. Plantings of GM crops have
risen from zero in the mid-1990s to more than 50 million hectares
planted worldwide by 2001, 68 per cent of all plantings taking
place in the United States. In terms of global crop production, 40
per cent of soy, 7 per cent of maize, 20 per cent of cotton and 11
per cent of oilseed rape were given over to GM production as
early as 2001.16 For the GM seed companies, the technology is
proving something of a bonanza, generating sales of US$3.67
billion in 2001 and forecast to grow more than 50 per cent to $5.57
billion by 2005.
Nutrigenomics is another line of research being pursued
within the emerging Life Sciences Integrated paradigm and, to
some extent, it typifies what that paradigm offers. Nutrigenomics
seeks to understand how nutrition and particular dietary intakes
interact with the structure and expression of genes and with
genetic pre-potential. Why can one person eat a diet high in fats
and not get cancer or heart disease, when another cannot?17 If it
were possible to unravel the interaction of genes, diet, ingredi-
ents and lifestyle, the promise of delivering an individualized or
personalized approach to food and health might be realized.
Nutrigenomics is the application of the new understanding
of genes and how they operate in plants, animals and micro-
organisms to help deliver that goal. Researchers try to unravel
the mechanisms involved – which foods and which ingredients
have an impact on which genes and which diseases. This would
have been inconceivable without the completion of the mapping
of the human genome by US and European geneticists.
Nutrigenomics promises a targeted fix to the diet and health
policy problem, based on an acceptance that both micronutrients
and macronutrients alter the metabolic programming of cells,
and on an understanding of how diet is a key factor in disease.18
The commercial as well as academic search is on for bio-active
ingredients which could be exploited for health.19, 20 For instance,
Guy Miller, head of Galileo Laboratories Inc, a US biotech com-
pany working in this area, has stated that:
24 FOOD WARS

by being able to elucidate genetic profiles of individuals, diets will be

formulated from crop to fork to confer prevention or retard disease
progression. As basic science advances converge with e-commerce, new
opportunities will emerge to deliver to consumers, whose genetic
susceptibility to specific diets and diseases are known, products tailored
to individual dietary needs.21

Although researchers are attracting funds to this work, realizing

health gains is probably some time off. Even if nutrigenomics
does yield more precise understanding of the diet–gene–health
connection, many observers consider that existing population
dietary advice still stands. Even if some people are more likely
to trigger degenerative diseases from eating a particular balance
of nutrients, the population as a whole would benefit from
attaining already known dietary goals such as restricting con-
sumption of saturated and total fats and increasing intake of
vitamins and trace elements from fruit and vegetables.
Nutrigenomics, argue the sceptics, may offer commercial
wealth by selling to the ‘worried well’ and rich consumers, but it
is probably of little relevance to global public health. Already
concerns have been raised. One concern is that big business logic
is outstripping the public’s ability to make informed choices.
Other ethical dilemmas relate to the problem of privacy and cost,
where a nutrigenomic test costs US$400.22 Nevertheless, nutri-
genomics suits the more individualized policy approach of
looking after one’s own health. It says little about the need to alter
the environment that reduces the chance of whole populations
taking exercise or consuming a wholesome diet.23
The Life Sciences Integrated paradigm is already informing
some key trends that are transforming food supply. It continues
to work within monocultural production and its commercial
structure is characterized by the concentration of large-scale
production processes and agribusiness companies operating on
a global scale. It is an unusual Food War in relation to health in
that large companies not usually associated with humanitarian
activism are now advocating that its technologies, particularly
genetic modification, be rapidly implemented in order to feed the
world.
GM biotechnology seems a near-perfect solution to the many
agribusiness problems of the Productionist paradigm, and
many experts in this area argue that GM plantings and scientific
 THE FOOD WARS THESIS 25

developments are the beginnings of a total revolution in pro-

duction. The former chairman and chief executive officer of
the leading biotechnology company Monsanto, Bob Shapiro,
articulated his confidence in GM technology in a letter to share-
holders in 1998: ‘. . . the previously separate domains of agri-
culture, nutrition and health should now be managed as an
interconnected system. We use the term “life sciences” to describe
that system.’24 But the troubles that Monsanto faced from pro-
testors in the late 1990s is a reminder of how demanding the
battle for the hearts and minds of consumers can be: Monsanto
was taken over by Pharmacia and Shapiro was retired as CEO.
Although the science and technology that is potentially shaping
the Life Sciences Integrated paradigm is at the cutting edge,
equally powerful scientific arguments are being proffered by its
critics who protest that it is little more than a modernization of
the Productionist paradigm, with the same weaknesses and
potential for damage. These concerns are what brought to greater
prominence a politically much weaker and, until recently, highly
fragmented body of scientific knowledge which we call the
Ecologically Integrated paradigm.
The Life Sciences Integrated paradigm is being supported by
considerable investment, mostly private but also public, and
mostly in the US. Biotech research expenditure in 2002 in the US
was €11.4 billion and €5 billion in the EU.25 A European survey in
1999 reported that eight countries represented 83 per cent of the
total funds spent on biotechnology. This state funding from the
European Union and its members was €712 million for plant
biotechnology and €674 million for animal biotechnology. 26
The corporate giants are tantalized at the prospect of biotechno-
logy becoming the defining science for the 21st century, while a
sizeable fraction of food capital – especially those companies
which are closer to consumers – remains hesitant about investing
in GM and is increasingly interested in the competing, but so far
marginal, Ecologically Integrated paradigm. A key concern, not
just for potential big-business supporters of either paradigm is
that the Life Sciences Integrated paradigm, far from freeing the
world from the agricultural treadmill and the commercial de-
pendencies of the Productionist paradigm, might chain us to
them. This is a battle that will ultimately be fought out in the
stock exchange, in company boardrooms and at the supermarket
shelves where consumers meet the food supply chain.
26 FOOD WARS

THE ECOLOGICALLY INTEGRATED PARADIGM

Since the 1930s, there has been persistent criticism of industrial
agribusiness which argues that agriculture, nutrition and health
are indeed interconnected and that it is workings of the Produc-
tionist paradigm that threatens that connection.27 The moral high
ground Monsanto was thinking it had discovered with its new
‘life sciences’ vision was already occupied by activists, policy-
makers, nutritionists, environmentalists and ecological and
biological scientists, not to mention tens of millions of consumers
whose reflex response is to be suspicious of anyone who tampers
with their food.
Ecological thinking on food is not new but remains mostly on
the outside track of mainstream policy-making. For example, in
his 1979 book The Sane Alternative, James Robertson outlined five
scenarios for the future which could be applied to food and
public policy.28 These were: business as usual; disaster; totali-
tarian conservatism; hyper-expansionism; and sane/human/
ecology. Trying to apply Robertson’s five scenarios to food,
Professor Joan Gussow argued that no meaningful proponent of
food in public policy could argue a case for the promotion of
‘disaster’. Further, since the ‘business as usual’ scenario would
ultimately lead to ecological disasters, and since the track record
of ‘totalitarian conservatism’ engenders mass resistance (often
yielding some form of democracy), within any democratic public
food policy there are only two meaningful scenarios to consider:
namely, ‘hyper-expansionism’ (with the world of food being
dominated by big business, biotechnology and factory farming,
among others), or ‘sane/human/ecology (which is the world of,
among other things, small-scale production and low inputs).29
In the sense we use here, the Ecologically Integrated paradigm
is also grounded firmly in the science of biology, but it takes a
more integrative and less engineering approach to nature. Its
core assumption recognizes mutual dependencies, symbiotic
relationships and more subtle forms of manipulation, and it aims
to preserve ecological diversity. It takes a more holistic view of
health and society than the more ‘medicalized’ one of the Life
Sciences paradigm.
In its thinking about agriculture, the Ecologically Integrated
paradigm framework corresponds closely to the body of thinking
 THE FOOD WARS THESIS 27

described as agroecology. 30 Agroecology is gaining support

among experts working with farmers in the developing world,
but it also offers a new vision of food for the developed world.
The world’s poor farmers and citizens facing food crisis can rely
only on self-reliance and small-scale farming; for them agro-
ecological technologies offer one of the few viable alternatives.
Cuba, for example, has become the global model of a successful
case study of sustainable agriculture using agroecology techno-
logies. Poor farmers in the developing world are synonymous
with traditional, sustainable agriculture, but often poorly served
by the top-down transfer-of-technology approach with its bias in
favour of modern scientific knowledge, and its application of
large-scale production methods. Agroecological methods, how-
ever, are re-discovering local skills and traditional knowledge,
but applied with modern understanding to meet the challenges
of food production. This is because a guiding principle of the
Ecologically Integrated paradigm is that diverse natural com-
munities are productive and should be supported.31 A hurdle to
overcome in this respect is the specificity of regional ecosystems
and the need for specialist local knowledge. This paradigm
therefore contrasts with the homogeneous technological pack-
ages characteristic of both the Productionist paradigm and the
Life Sciences Integrated paradigm, relying upon bio-pesticides
technologies to combat insect pests and develop resistant plant
varieties and crop rotations; on microbial antagonists to combat
plant pathogens and produce better rotations; and on cover
cropping to suppress weeds, replacing synthetic fertilizers with
bio-fertilizers. There is an increasing emphasis on skills and
knowledge management in contrast to the single technician
managing thousands of hectares on a ‘recipe’ basis; it would re-
link the people with the land, encourage small-scale management
units and return alienated farm workers to the land.
Agroecology is emerging as the discipline that provides the
basic ecological principles of the study, design and management
of agroecosytems with a view to productivity conserving natural
resources, and to systems that are culturally sensitive, socially
just and economically viable.32 Such technologies include organic
matter accumulation, nutrient cycling, soil biological activity,
natural control mechanisms (disease suppression, biocontrol of
insects and weeds), resource conservation and regeneration (to
include soil, water and germplasm), general enhancement of
28 FOOD WARS

agrobiodiversity and synergisms between components. The

agroecology model, however, has yet to demonstrate its wide-
spread applicability, not only in the developing, but also in the
developed world. More work is needed clearly to demonstrate
how the Ecologically Integrated, like the Life Sciences Integrated
paradigm and the Productionist paradigm will offer viable
alternatives for the future of food supply.
A key distinction is that within the Ecologically Integrated
paradigm, thinking ecologically about health requires a consider-
ation of the circumstances, experiences and dynamics of groups
and populations.33 Individual and population health depends
upon the stocks of natural resources, the functioning of eco-
systems and cohesive social relations. The Ecologically Inte-
grated paradigm is integrative, not disintegrative: whereas the
Life Sciences Integrated paradigm’s vision for agriculture relies
heavily on the laboratory, the Ecologically Integrated paradigm
asks: why develop seeds modified to resist pesticides so that the
company that owns the intellectual property to both can prosper?
It claims that new regimes of mixed planting of crops can provide
successful alternatives with fewer risks, either to the environ-
ment, to consumer acceptance or to human health.34

THE THREE PARADIGMS SUMMARIZED

The three paradigms, although explored throughout this book,
are so central to our thinking and arguments that we now
provide a summary of each: Table 1.1 of the Productionist para-
digm (page 29), Table 1.2 of the Life Sciences paradigm (page 31),
and Table 1.3 of the Ecologically Integrated paradigm (page 32).
All three paradigms share some features. Although we charac-
terize the Productionist paradigm, for example, as more focused
on quantity than quality, in fact all paradigms take a position on
quality; Productionism, for instance, takes a cosmetic approach.
Similarly, all paradigms assume some kind of market economy,
and have concerns, for example about competition practices and
control of markets. Throughout the food supply chain, adherents
of each of the paradigms know the importance of macro-econ-
omic frameworks such as the rules for trade and the need to
deliver food safety; the Productionist paradigm, for instance, was
 THE FOOD WARS THESIS 29

in part born out of evidence from the 1930s about the waste of
food due to problems of storage and losses due to contamination,
notably in the developing world.
And even today, while both the Ecologically Integrated and
Life Sciences Integrated paradigms promote an environmental
dimension, they differ on how they deliver it: how, for instance,
to optimize use of resources such as land, energy, chemicals and
water. Both paradigms see biology as central, but, whereas the
latter looks to biology to control the relationship between food
and health, the Ecologically Integrated paradigm views this
position as biological reductionism; the Life Sciences Integrated
Paradigm posits that food is to be (re)made applying the advances
in biological science and the unity of thinking between chemistry,

Table 1.1 Features of the Productionist paradigm

Drivers commitment to raise output; immediate gains sought

through intensification
Key food sector commodity markets; high-input agriculture; mass
processing for mass markets
Industry approach homogeneous products; pursuit of quantity and
productivity (throughput) over quality
Scientific focus chemistry + pharmaceuticals
Policy framework largely set by agriculture ministries; reliance on
subsidies
Consumer focus cheapness; appearance of food; homogeneous
products; convenience for women; assumes safety
of foods
Market focus national markets; emergence of consumer choice;
shift to branding
Environmental cheap energy for inputs and transport; limitless
assumptions natural resources; monoculture; externalization of
waste/pollution
Political support historically strong but declining, as reflected in policy
battle over subsidies
Role of knowledge agroeconomists as important as scientists
Health approach marginal interest; assumes that health gains follow
from sufficiency of supply
30 FOOD WARS

biology, engineering and management control, whereas the

Ecologically Integrated paradigm argues that biology has to be
approached from a less controlling perspective: working with
nature, rather than on it, is its ethos. Thus, a key distinction be-
tween the paradigms is not just what they propose in science but
what forms of control and ownership they represent. For exam-
ple, the paradigms differ in how they view commercial control
over intellectual property and whether they appeal to the more
controlling or the more democratic elements in society.
It should also be noted that the paradigms can be inter-
preted differently in political terms: early proponents of the
Ecologically Integrated paradigm, for instance, were linked to
both far right and more democratic ‘left’ political movements,
the former interpreting ‘nature’ in authoritarian terms and argu-
ing that hierarchies and top-down rules are essential to allow
intrinsic values to be asserted. The left position, in contrast,
argued that ecology needed champions to protect it from the
depredations of advanced capitalism.35 Although Tables 1.1, 1.2
and 1.3 (pages 29–32) highlight differences, it should be noted
that all the paradigms have a strong health orientation; the role
of the food supply chain is to deliver health. But as the rest of this
book explores, what is meant by health, and what the deter-
minants of health are, are matters of conjecture.

WHICH WILL DOMINATE?

There are many obstacles to the widespread adoption of health
alternatives, the greatest presented by political–corporate power
and vested interests. Yet at times there is a psychological barrier
to believing that the alternatives can work. The Ecologically
Integrated paradigm is currently the underdog in the contest for
paradigmatic dominance but its chances have been significantly
improved by the growth of environmental and consumer resist-
ance to GM foods. By contrast, the reputations of the life sciences
companies are being tarnished by their association with the
economic, ‘neo-liberal’ rhetoric which argues that consumers
should be given a choice; yet when consumers demand labelling
of foods that contain GM ingredients, they are sometimes accused
of being anti-science or Luddites. In practice, as has occurred
with soya, the uptake of GM seed by farmers in the US has meant
 THE FOOD WARS THESIS 31

Table 1.2 Features of the Life Sciences Integrated paradigm

Drivers science-led integration of food supply chain; tight

managerial control
Key food sector capital-intensive use of Life Sciences (agrofood); food
retailers dominate supply chain; reliance on intensive
agriculture for economies of scale
Industry approach aims for industrial-scale application of biotechnology
primarily in agriculture but increasingly in
manufacturing (enzymes not just GM); uses a mixture
of chemical and biological inputs
Scientific focus links genetics, biology, engineering, nutrition; control
from laboratory to field and factory; science
presented as neutral but tailored by industry-led/
oriented funding
Policy framework top-down, expert-led; backed by trade and finance
ministries; challenges regulatory, industry, policy and
public boundaries
Consumer focus production of ‘champion’ products (eg functional
foods to appeal to individual choice); structured
choice; food features can be designed to appeal to
market-derived characteristics
Market focus global ambitions; large companies dominate; ‘Life
Science’ fix is the only mainstream business model
Environmental intensive use of biological inputs; claims to deliver
assumptions environmental health benefits
Political support fast-developing; divisions among both rich and poor
countries about how to interpret Life Sciences
paradigm
Role of knowledge top-down; expert-led; hi-tech skills; laboratory science
base
Health approach relies on novel but unproven impact; argues that
health can be fixed technically by new combination of
screening on an individualized basis; seeks to
improve beneficial traits of crops for human health

that there is little choice: with ingredients derived from GM soya

already in use by food processors, it is hard for even the most
dedicated activist actually to avoid consuming GM-derived
products.
32 FOOD WARS

Table 1.3 Features of the Ecologically Integrated paradigm

Drivers environmental; energy/waste reduction; diversity

‘ground upwards’; reduction of certain inputs; aims
for diversity on and off the field; risk minimization by
building diversity

Key food sector integration of all; but emphasis on whole-farm

systems approach (land and watersheds); biodiversity
enhancement to stabilize and maximize yields over
the long term

Industry approach aims to move organic foods from marginal to

mainstream; nervous about increasing the scale of
production and capacity of quality controls; select
use of biotechnology (fermentation, not GM)

Scientific focus biology; ecology; multidisciplinary; agroecological

technology instead of chemicals

Policy framework partnership of ministries; collaborative institutional

structures needed; promotes advantages of
decentralization and team-work

Consumer focus citizens not consumers; improved links between the

land and consumption; greater transparency

Market focus regional and local focus – ‘bio-regionalism’; nervous

about export-led agriculture; favours smaller
companies but increasingly adopted by larger ones

Environmental resources are finite; need to move away from

assumptions extensive monoculture and reliance on fossil fuels;
need to integrate environmental, nature and
conservation policy with industrial and social policy

Political support weak, but low base strengthening in many countries;

some merging of fragmented ‘movements’ claiming
high ground

Role of knowledge knowledge-intensive, rather than input-intensive;

skills needed across whole supply chain; knowledge
as empowerment

Health approach presents itself as ‘healthy’ alternative but as yet on a

weak evidence base; promotes diet diversity
 THE FOOD WARS THESIS 33

It would be wrong to dub the Ecologically Integrated para-

digm as reactionary, anti-science or anti-big business: it offers a
particular view of science, business and consumption, aiming to
prove it can be ‘big’ in the sense of ensuring a viable food econ-
omy in developed world markets. In contrast, one of the strengths
of the Life Sciences Integrated paradigm is that it has immense
influence in the corridors of power and also among the decision-
makers in many large food companies. It also builds on the struc-
tures of the Productionist paradigm which has proven remark-
ably successful in food output. Meanwhile, the Ecologically
Integrated paradigm still remains marginal in mainstream
food business and is often portrayed as quirky or backward-
looking. But while this image may be changing due in part to its
popularity with consumers and the media, its scientific basis is
growing in stature and evidence in both developed and develop-
ing countries. This is the hard business logic for supporting
ecological production and we predict increasing polarization be-
tween those companies tending towards the values and culture
of the Ecologically Integrated paradigm and those favouring the
Life Sciences Integrated paradigm. A key battleground is already
the regulatory arena – which products can get approved, with
what scientific evidence and credibility? – but there is also a
battle ahead for access to public monies and political credibility
to support the development of different paradigms.
Thus, the existing Productionist paradigm will be the inevit-
able opponent in protracted Food Wars because its methods have
been demonstrated to be unsustainable and harmful to human
and environmental health (see Chapters 2 and 6). Only two
new contenders will battle it out for future dominance; both are
science-based; both make claims to environmental and human
health benefits. It is important to remember that Professor
Thomas Kuhn, who coined the notion of paradigm shifts in
science, acknowledged that two paradigms can coexist. This may
be the case for food, in which case an ever-present danger is that
there will be a polarized food supply shaped by competing
paradigms. The tragedy would be if this supply polarized around
choices available only for the food-rich at the expense of the food-
poor.
One scenario is not a period of mutual tolerance between the
paradigms but an era of serious conflict, with proponents seeing
little middle ground. If the Life Sciences Integrated paradigm
34 FOOD WARS

becomes well ensconced in the corridors of power, the Ecologic-

ally Integrated paradigm may have greater public acceptance
(Chapters 4 and 5 explore the drivers of actual behaviour more
closely), and vice versa.

THE PLACE OF FOOD AND HEALTH IN THE

‘PARADIGM’ FRAMEWORK
In the Productionist paradigm (Figure 1.3), health is portrayed as
being enhanced, above all, by increasing production, which
required investment in both monetary and scientific terms.
Agriculture, the prophets of Productionism argued, deserved
massive support if it was to move away from ‘peasant’, low-yield
systems.36 (This, incidentally, was their rationale for the now
much-derided subsidy system throughout the West.) As long as
food could be adequately and equitably distributed, health
benefits would result. This Productionist view of health saw the
main problems as under-consumption, under-production and
poor distribution. The health goal of public policy, therefore,
should be to increase production of key health-enhancing ingre-
dients such as milk, meat, wheat, and other ‘big’ agricultural
commodities.37 Figure 1.3 shows how this policy relationship
might connect inputs and outputs in health.
The health assumptions on which the Productionist paradigm
was built were based on what today would be regarded as a very
narrow understanding of nutrition and health. For example, the
observation in the 1800s that animal protein aided human growth
led to massive resources in countries such as the US and Europe
being invested in the development of the dairy and meat indus-
tries.38 The agricultural and agribusiness focus of the Produc-
tionist paradigm has also been weakened by the shift of power
and finance down the food supply chain to the retailing, trade
and consumer industries such as food service, where most of the
money from food is now made (a feature spelled out in Chapter
4). In the US, for example, about half of all food expenditure is
on consumption outside the home.
This change in consumption patterns suggests just how out
of touch the Productionist paradigm is with health needs. Public
policy responses from within the Productionist paradigm look
 THE FOOD WARS THESIS 35

Figure 1.3 Productionist approach to health (1950s to present, with

‘health education’ included post 1970s)

increasingly like rearguard actions, when just half a century ago

it promoted a proactive approach – policy intervention, new
initiatives and new ways of farming. Today, the paradigm is
increasingly reliant on drugs, special foods with purported
health benefits and fringe crops to try to gain a foothold in ‘health
36 FOOD WARS

consumer’ markets. No longer does it drive and structure the

food supply chain in a way that makes sense for health. (We
expand on this theory in Chapter 2.) Even in developing coun-
tries, the paradigm has problems. For example, the Green Revo-
lution, while delivering more energy-rich macronutrients, has at
the same time exacerbated rates of maternal anaemia and child-
hood deficiencies in iron, zinc and betacarotene because the
higher-yielding strains of wheat and rice contain relatively fewer
micronutrients.39
In addition, with support from World Bank and International
Monetary Fund policies, the Productionists encouraged the pro-
duction of cash crops in order to increase income. ‘Health educa-
tion’ was bolted on in the face of growing evidence about the
impact of diet on cardiovascular diseases.40 Rather than rethink
the paradigm, governments and corporate interests decided
simply to put dietary warnings in place. In other words, the
policy was to tell consumers to eat more sensibly and to look after
themselves. They were bombarded with leaflets and public
education programmes, with only mixed results. Other areas of
health education, such as nutritional labelling, became hotly
contested areas within food policy, rather than being a channel
of information to alter the relationship between supply and
demand. The paradigm’s policy solutions thus took highly indi-
vidualized approaches, and nutrition became an increasingly
politically charged issue (this is discussed further in Chapter
3).41, 42
The Productionist paradigm encouraged a reductionist view
of the relationship between food and health: that food’s contribu-
tion to health comes from the ‘right’ ingestion of the ‘correct’
balance of ingredients. There is no good or bad food, according
to this ethos, only good or bad diets. The onus of responsibility
for diet-related health is thereby put on consumers – mainly
through what they were expected to read and interpret from food
labels. Health was defined as the absence of disease. If consumers
wanted to improve their life-expectancy chances, they should eat
healthy foods. The old Roman statement of consumer responsi-
bility – caveat emptor: ‘buyer beware’ – prevailed.
We take issue with this ‘production-led’ position. As we show
in Chapter 2, much of diet-related health, like health itself, is
socially determined.43 Yet although we have many reservations
about the Productionist model – and note too that the failure to
 THE FOOD WARS THESIS 37

ensure equitable distribution of food is not entirely its fault – it

has been spectacularly successful in its own key terms. Outputs
and total yields have increased, albeit more in some developed
areas of the world due to land ownership and macro-economic
policies,44 a welcome fact, given the world reality of too many
people chasing too little food. 45 The world’s population has
doubled since the 1950s, yet the rate of hunger has dropped,
notwithstanding that 800 million people still face daily hunger,
but millions of new mouths have been fed by rising outputs and
this has to be judged a major success.
But has the Productionist paradigm run its course? The
current era of the Food Wars (see Figure 1.2 on p18) suggests
global doubts about sustainability. Evidence is mounting as to its
financial costs to the taxpayer; there are also costs in human and
environmental health and, just as importantly, doubts that the
current food system can deliver the requisite amount, range and
quality of foods needed for 9 billion mouths predicted for the
world by the mid-21st century.
Within our paradigm-based analysis, it is important to note
that neither emerging paradigm replicates the elitist bias of the
Productionist paradigm which favours wealthy individuals in
developed nations over their poor counterparts in other parts
of the world. A policy priority must be the capabilities of the
working classes and the poor to feed their families.

THE LIFE SCIENCES AND ECOLOGICALLY

INTEGRATED PARADIGMS’ APPROACHES
TO HEALTH

Increasing the food supply is still a critical policy concern, and

one espoused in particular by the Life Sciences paradigm’s
approach to health, with its focus on individualized health
(Figure 1.4). It offers an almost industrial model of health in that
it promises the capacity to understand the constituent parts of
disease and the human’s capacity to fall prey to particular dis-
eases, and then offers long-term personalized dietary solutions,
such as nutrigenomics, implying a highly sophisticated under-
standing of the minutiae of the biological and genetic ‘cogs’ in the
human ‘machine’. The Life Sciences approach disaggregates the
38 FOOD WARS

Figure 1.4 Life Sciences Integrated approach to health

complexities of the food–disease–health nexus into discrete parts

and offers food or food-derived ingredients as potential aids:
health is delivered by science.
A fundamental difference between the Productionist and the
Life Sciences paradigms on one hand, and the Ecologically Inte-
grated paradigm (Figure 1.5) on the other hand, is that the first
two paradigms conceive of health as an outcome of a long process
 THE FOOD WARS THESIS 39

Figure 1.5 Ecologically Integrated approach to health

(the food chain or bio-food chain), while the latter conceives of

health as something that is intrinsic to each stage of the growing
and distribution process. Both emerging paradigms, we repeat,
build on the new understanding of the centrality of biology to
life.
The health approach of the Ecologically Integrated paradigm,
as the name implies, is centred on ecology: understanding the
working of systems and cycles that are characteristic of biological
systems in nature. The emphasis is on process – notably feedback
loops, cycles, symbiosis and interconnections. It proposes that the
goal of food policy should be to understand these processes and
to work with them, rather than to engineer, constrict or fragment
them. For example, an Ecological approach sees monoculture,
whether in the field or in diet, as anathema, whereas the other
two paradigms see monoculture as a matter of business reality
and efficiency – specialism being the route to enterprise.
40 FOOD WARS

Both alternative paradigms claim to deliver environmental

and health benefits that they say are not being delivered by the
Productionist paradigm: reduced chemical inputs, foods with
better nutrient profiles, and food security. Both believe that the
Productionist approach will be unable to deliver enough food
for burgeoning world populations, or not without unbearable
dislocation.
Where the paradigms differ, however, is on how to deliver
that food increase and its assumed benefits to the general health.
The Life Sciences paradigm is espoused by the agrochemical and
pharmaceutical end of the food system while the Ecologically
Integrated paradigm looks to learn from and modernize more
traditional farming knowledge. Both embrace concepts of intel-
lectual property, the Life Sciences through the patenting of
genetic materials, the Ecologically Integrated paradigm by build-
ing on and modernizing knowledge built up over many genera-
tions. The Life Sciences paradigm argues that its technologies will
deliver human and environmental health.

ENDING THE FOOD WARS THROUGH

POLICY AND EVIDENCE
In Figure 1.2 (page 18), the depiction of the era of the Food Wars
features the symbol of the crossed swords used by historians and
map-makers to designate the site of a battlefield.
The war analogy is apt: unnecessary millions of lives are
being lost by the way that the food economy currently operates.
The wars might go on sometimes behind closed doors in board-
rooms as well as in parliaments and intergovernmental dis-
course, but the battles for supremacy are very real: lives hang on
their outcome; people get hurt in the clashes. The Food Wars
must come to an end, but when and with what result?
In wars, propaganda prevails. In the last decade, UK citizens,
for instance, have become only too aware of how, when the
sordid tale of bovine spongiform encephalopathy (BSE) or ‘mad
cow disease’ unfolded, very powerful vested interests in the food
chain – exporters, farmers and other interests – fought to present
the risks as either being under control or not serious.46, 47 As we
write (in spring 2004), the death toll from the human variant of
 THE FOOD WARS THESIS 41

BSE, variant Creutzfeldt-Jakob Disease (vCJD), is 139 in the UK,48

with a handful of cases in other countries. Although this number
has had huge political attention – and led to the restructuring of
European food control systems and the creation of food agencies
to attempt to recapture public confidence in the ability of govern-
ments to protect consumers – the huge death rate due to diet-
related ill health – such as the 300,000 annual deaths in the US
related to obesity – is somehow accepted as unavoidable.49 Both
forms of premature death and distress should be unacceptable.

CAPTURING THE CONSUMER

A healthy diet – one low in saturated fats (eg dairy and meats)
and sugars, and high in fruits and vegetables and a diversity of
foods – also has benefits on environmental grounds. The trend
towards the Westernized diet with its high content of meat
and dairy, and a reliance on a narrow range of crops is warping
and distorting ecology. The rhetoric of economic neo-liberalism
has long accorded consumers primacy; they are said to be the
keystone of why market economies deliver efficiencies. Yet in
practice consumers are under-informed, sometimes patronized
and heavily targeted by marketing and sponsorship. High calor-
ific foods such as burgers and soft drinks are relatively cheap;
labelling does not compensate for price signals. For example,
nutritional labelling is mandatory in the European Union only
once a health claim has been made. Choices – particularly by
children – are easily influenced by heavy advertising and cause-
related marketing.50 Image is everything.
The focus on the consumption end of the chain food chain has
led to a reinvention of industries dedicated to the marketing and
branding of foodstuffs. Major food brands mostly emanating
from the West have consolidated their position and are being
promoted worldwide, entering Eastern and Southern markets
and changing dietary patterns.51, 52 However, in developed coun-
tries, health has become a marketing battleground with increas-
ing awareness of the links between diet and disease in a rapidly
ageing population. Consumers are demanding products with
health benefits, a demand which the food industry now is scrab-
bling to satisfy (see Chapter 5).
42 FOOD WARS

The key issue here for policy is whether a proliferation of

particular products with presumed health benefits is the right
solution to diet-related ill health, as is often claimed by the food
producers. After decades of being highly resistant to the evidence
that our food has an impact on ill health,53, 54 large sectors of the
food industry now, ironically, see health as a potential growth
area. At first sight, this is welcome but there is a real danger that
this will either be a short-lived technical fix or merely create a
new niche – ‘health’ – in already saturated markets.
Another fundamental concern is what sort of food culture is
emerging. Many food traditions and common eating behaviours
are altering rapidly in the face of new products, marketing and
lifestyles. There is rampant ‘burgerization’, for one thing – the
domination of US-style fast food, often washed down by soft
drinks across the whole developed world. (Americans them-
selves now spend more per annum on fast food than on higher
education, personal computers, computer software or new cars.)55
In addition, marketing departments of food companies often
celebrate their role in offering consumers an astonishing range of
choice. But this choice comes at considerable environmental cost
– long-distance trucking, excessive energy use, monocropping on
intensive farms – as well as the health costs of obesity, diabetes
and other degenerative diseases (see Chapter 6).

EVIDENCE-BASED POLICY?
Why is policy not being changed and what is stopping such
change? Why does the Productionist paradigm have such a grip
in the face of increasing weight of ‘evidence’ as to its shortcom-
ings? Indeed, food policies and processes tend to be developed,
not by evidence, but by political expediency and much more. If
policy were based on evidence we would see, for example,
immediate action utilizing all available policy levers to deliver a
reduction in the incidence of heart disease and diet-related
cancers.56, 57 Instead, there have been decades of delay and obfus-
cation. The diet-related epidemics of heart disease, cancers,
obesity and diabetes are now spreading to the South. Of deaths
from all chronic diseases, 72 per cent occur in low and lower-
middle income countries.58 Approximately two-thirds of all
 THE FOOD WARS THESIS 43

cardiovascular disease deaths before the age of 70 years are now

occurring in developing countries.59 As noted, in the US alone
300,000 annual deaths are associated with obesity.60 Worldwide,
according to the WHO, there are more than 1 billion adults
overweight and 300 million clinically obese,61 leading to 3 million
deaths annually from overweight and obesity.62
In addition to mortality, there is also morbidity – the loss of
capacity due to suffering and days lost at work, representing
considerable external costs. Yet for the last decade or so politi-
cians and policy-makers have claimed that food safety is the
main issue in food policy. In the European Union, for instance,
1.5 million premature deaths occur annually due to heart dis-
ease,63 yet political attention within Member States and in the
European Commission (the civil service) has been dominated
by food safety, which in fact accounts for relatively few deaths.
Obesity rates, by contrast, are rising alarmingly worldwide and
the WHO now describes obesity as an epidemic.64 The associated
health costs have long been documented,65, 66 yet leading politi-
cians and world policy-makers hold to the notion that exercise
and diet are solely issues of individual choice, as though the
proliferation of foods based on saturated or hydrogenated fats,
sugars and refined carbohydrates, and the sophisticated market-
ing techniques used to promote them, are not critical components
of the health crisis.
The evidence about environmental damage is similarly over-
whelming.67 This includes falling water tables (especially in key
areas of agricultural production), the deterioration of range lands
which supply most of the world’s animal protein; soil erosion and
loss of top soil to grow crops, and the continuing destruction of,
and damage to, croplands.68 Above all, we will later point to the
collapse of global fisheries and climate change.
Already, it should be clear that this book explores the prob-
lematic and often highly contentious relationship between evid-
ence, policy and practice. It is often argued in modern medicine
that practice should be based only on solid evidence. This so-
called Cochrane ‘gold standard’ approach argues that health care
should be based on an excellent quality of evidence. The Coch-
rane Collaboration is a network of 50 review groups around the
world, made up of health specialists committed to systematic
reviews of the effects of health-care intervention. Such reviews
should be rigorous, and based on peer-reviewed journals (rather
44 FOOD WARS

than the ‘grey’ literature that has not gone through the anony-
mous process of peer review), and take note of first-rate evidence,
ideally from placebo-controlled double blind studies, and so
on.69 There are good grounds for arguing that a Cochrane-type
approach could be applied to nutrition interventions.70 The ideal
relationship between policy and evidence requires an increase in
the availability of evidence to which policy-makers have to listen.
In practice, the relationship between food policy and evid-
ence falls into a number of discrete possibilities which include the
following:

l Policy with evidence.

l Policy without evidence.
l Policy despite evidence.
l Policy burying evidence.
l Policy claiming evidence.
l Evidence searching for a policy.
l Evidence but no policy.
l Evidence despite or in the face of policy.
l Evidence in line with policy.

In our view there is enough evidence to know that the current

post-World War II Productionist paradigm of food and farming
is no longer credible. Its impact on health is sufficiently counter-
productive for the judgement that its time is up to be safely
delivered to policy-makers. Therein lies the credibility of the Life
Sciences Integrated and Ecologically Integrated paradigms –
neither would be so credible if it was not for the gaping human
and environmental failures in the Productionist paradigm.
What is missing is a more innovative and organized health
lobby to pursue and ensure a change in policy-making in relation
to food and health. Figure 1.6 illustrates the breadth of thinking
and policy input that is now required in the decision-making
process and in the management and delivery of food policy. The
ministries which affect food supply include health, trade, envi-
ronment, agriculture and food, fisheries, consumer protection,
development, foreign affairs and industry, but rarely is there a
constructive dialogue across these ministries.
Why is there no reasoned, coordinated overview with ration-
ally derived concerns to drive food and health policy? Is govern-
ment controlling the food supply chain or is it the other way
 THE FOOD WARS THESIS 45

Figure 1.6 The food policy web

round? Is commerce framing public policy? Too often public

policy-making is ad hoc or gets distracted by special pleas and
particularities when what is needed is some long-term strategic
thinking. Ironically, commercial interests do tend to take much
longer-term strategic views. Governments come and go, and
work to short-term horizons. The mismatch between public and
commercial policy is particularly worrying. It is now time for
reform. Long-term health must be the key driver of any local,
national, regional and global food supply chain. The benchmark
must be policy’s impact upon positive human and environmental
health outcomes. This will also require institutional reform (an
issue which is taken up in Chapters 7 and 8).
One thing is already certain. Food policy is moving from a
prime concern with raising productivity at any cost to address-
ing, at the very minimum, sustainable production and a more
wary consumer response and food consciousness. There is a real
danger that the Food Wars may themselves become the dominant
ethos of the age, rather than the pursuit of resolution – a new
peace. Food is highly sensitive and can be a weapon of control.
Food’s impact on health requires that it be produced, distributed
and maintained in ways that do not threaten the ecosphere.
The public health movement – all those professions, institu-
tions and organizations dedicated in principle to promoting
better public health – has been marginalized in the debate about
the future of food and on the direction that food policy could go,
46 FOOD WARS

when it has much to contribute to the debate about the shape and
purpose of the food chain. If public health affects everyone and
everything, it ought to be central to the debate about food policy.
There are some welcome signs that the proponents of the public
health are stirring. New arguments and a new preparedness to
stand up against the easy ideological route of individual choice
and market forces is seen on occasions. The evidence mounts.71
This is one good result from the sudden policy interest in obesity,
after years in which it was ignored or downplayed.
Key questions for the future of food addressed in this book
include:

l Who eats and what?

l Who controls access to food?
l How is food grown and processed?
l How is it traded and distributed?
l How is food supply regulated?
l Who and what shapes food policies?
l How is its impact on society and the environment addressed?

A new conception of health has to be at the heart of the reshaping

of the food supply and this will require new imagination from all
drivers of food policy.
 DIET AND HEALTH: DISEASES AND FOOD 47

CHAPTER 2
DIET AND HEALTH:
DISEASES AND FOOD

‘Let Reason rule in man, and he dares not trespass against his fellow-
creature, but will do as he would be done unto. For Reason tells him, is
thy neighbour hungry and naked today, do thou feed him and clothe him,
it may be thy case tomorrow, and then he will be ready to help thee.’

Gerrard Winstanley, English Leveller, 1609–16761

CORE ARGUMENTS
The Productionist paradigm is critically flawed in respect
of human health. Half a century ago it responded to issues
then seen as critical but which now require radical revi-
sion. While successfully raising the caloric value of the
world food supply, it has failed to address the issue of
quality, and as a result, there is now a worldwide legacy
of externalized ill-health costs. The world’s human health
profile is now very mixed. Within the same populations,
in both developed and developing countries, there exists
diet-related disease due both to under- and over-con-
sumption. The pattern of diet that 30 years ago was associ-
ated with the affluent West is increasingly appearing in the
developing countries, in a phenomenon known as the
‘nutrition transition’: while the incidence of certain diet-
related diseases has decreased, such as heart disease in the
West, others are increasing, particularly diabetes and obes-
ity worldwide, and heart disease in the developing world.
Massive global inequities in income and expectations
contribute to this double burden of disease, and current
policies are failing to address it.
48 FOOD WARS

INTRODUCTION
One of the key Food Wars is over the impact of the modern diet
on human health. In the last quarter of the 20th century, nutrition
moved from the sidelines of public health to being central to the
marketing of foodstuffs, and major public health campaigns
urged consumers to improve their diets.
This human health dimension is central to our critique of the
Productionist paradigm in two respects. First, even though
global food production has increased to meet caloric needs, its
nutritional content may be less than desirable. Second, food
distribution remains deficient: nearly a billion people remain
malnourished. In this chapter, we explore the relationship be-
tween diet and the range of disease and illnesses that are associ-
ated with food choices. We discuss, too, the existence of gross
inequalities within and between countries in the form of food
poverty amidst food abundance and wealth.
In late 2002 and 2003, a wave of new public health reports
reminded the world that diet is a major factor in the causes of
death and morbidity. Although deeply unpalatable to some
sections of the food industry, these reports were sober reminders
of the enormity and scale of the public health crisis. The joint
WHO and FAO’s 2003 report on diet, nutrition and the preven-
tion of chronic diseases drew attention to high prevalence of
diseases which could be prevented by better nutrition, including:2

l obesity;
l diabetes;
l cardiovascular diseases;
l cancers;
l osteoporosis and bone fractures;
l dental disease.

Of course, these diseases are not solely exacerbated by poor diet

but also by lack of physical activity. In truth, this report was only
reiterating the story of nutrition’s impact on public health that
had been rehearsed for many years, and the evidence for which
was judged to be remarkably sound, but as Dr Gro-Harlem
Brundtland, then the Director-General of the WHO, stated in the
report: ‘What is new is that we are laying down the foundation
for a global policy response.’ To this end, the WHO set up an
international consultation dialogue to prepare its global strategy
 DIET AND HEALTH: DISEASES AND FOOD 49

on diet, physical activity and health, scheduled to be launched

in 2004. By international agency standards, this relatively speedy
shift from evidence to policy-making indicates the real urgency
of the problem. The draft strategy was launched ahead of sched-
ule in December 2003.3
Already by 2002, the WHO had produced a major review of
the national burdens that such diseases cause. Of the top ten risk
factors associated with non-communicable diseases, food and
drink contribute to eight (with the two remaining – tobacco and
unsafe sex – are not associated with diet and food intake):4

l blood pressure;
l cholesterol;
l underweight;
l fruit and vegetable intake;
l high body mass index;
l physical inactivity;
l alcohol;
l unsafe water, sanitation and hygiene.

In the 2003 World Cancer Report, the most comprehensive global

examination of the disease to date, the WHO stated that cancer
rates could further increase by 50 per cent to 15 million new cases
in 2020.5 To stem the rise of this toll, the WHO and the Interna-
tional Agency for Research on Cancer (the IARC) argued that
three issues in particular need to be tackled:

l tobacco consumption (still the most important immediate

avoidable risk to health);
l healthy lifestyle and diet, in particular the frequent consump-
tion of fruit and vegetables and the taking of physical activity;
l early detection and screening of diseases to allow prevention
and cure.

In addition to these UN reports, the International Association for

the Study of Obesity (the IASO) revised its figures of the global
obesity pandemic: it estimates that 1.7 billion people are over-
weight or obese, a 50 per cent increase on previous estimates. The
IASO’s International Obesity Task Force stated that the revised
figures meant that most governments were simply ignoring one
of the biggest risks to world population health.6
50 FOOD WARS

These reports testify to an extensive body of research and

evidence from diverse sources around the world of the link
between food availability, consumption styles and specific pat-
terns of disease and illness. Table 2.1 confirms some of the diet-
related causes of death throughout the world. Good health and
longevity were intended to result from ensured sufficiency of
supply; at the beginning of the 21st century, far from diet-related
ill health being banished from the policy agenda, it appears to be
experiencing a renewed crisis.
Under the old Productionist paradigm, the main focus was
under-nutrition. Yet at the end of the 20th century, with diseases
such as heart disease, cancers, diabetes and obesity rampant
worldwide, not just in the affluent West, a new focus must be
placed on diet and inappropriate eating. In this chapter, we begin
to explore wider societal changes which impose progress in this
regard through demographic shifts, maldistribution of and poor
access to food, and spiralling health-care costs. These factors add
weight to our argument that the Productionist paradigm is
beyond its own sell-by date.
Policy-making is failing to address the causes of these food-
related health problems and too often resorts to only palliative
measures. This is partly because the Productionist paradigm’s
approach to health narrows the framework for considering
alternative solutions: by being centred on striving to increase
output, it has taken only a medicalized, rather than a socially
determined, view of health.
Could the proponents of Productionism have anticipated the
scale of these most recent health concerns? To some extent, they
could not. Even excessive intake of fats as causing ill health might
have been something of a shock for the Productionist paradigm,
as it was almost heretical to argue that too much of a nutrient
could be harmful to health.9 Part of the problem here was the
essential paternalism of the paradigm which assumed total
knowledge of all variables needed to make good food policy;
governments and companies could be trusted to look after the
public health; the consumers’ role was to select products to create
their own balanced diets. Recent history, however, has shown
that governments and the food supply chain failed to adapt to
new scientific knowledge in relation to food and health. Nation-
ally and internationally, the influence of health scientists on
public policy has been minimal. Consumerism triumphed.
 DIET AND HEALTH: DISEASES AND FOOD 51

Table 2.1 Some major diet-related diseases

Problem Extent/comment
Low birthweights 30 million infants born in developing countries
each year with low birthweight: by 2000, 11.9 per
cent of all newborns in developing countries
(11.7 million infants)
Child under-nutrition 150 million underweight pre-school children: in
2000, 32.5 per cent of children under 5 years in
developing countries stunted, amounting to 182
million pre-school children. Problem linked to
mental impairment. Vitamin A deficiency affects
140–250 million schoolchildren; in 1995 11.6
million deaths among children under 5 years old
in developing countries.
Anaemia Prevalent in schoolchildren; maternal anaemia
pandemic in some countries.
Adult chronic diseases These include adult-onset diabetes, heart
disease and hypertension, all accentuated by
early childhood under-nutrition.
Obesity A risk factor for some chronic diseases (see
above), especially adult-onset diabetes.7
Overweight rising rapidly in all regions of the
world.
Underweight In 2000, an estimated 26.7 per cent of pre-
school children in developing countries.
Infectious diseases Still the world’s major killers but incidence
worsened by poor nutrition; particularly affects
developing countries.
Vitamin A deficiency Severe vitamin A deficiency on the decline in all
regions, but sub-clinical vitamin A deficiency still
affects between 140 and 250 million pre-school
children in developing countries, and is
associated with high rates of morbidity and
mortality.
Source: adapted from ACC/SCN 20008

To some extent, too, the public health world has colluded in its
own marginalization from ‘live’ policy-making by its fixation
with deficiency diseases: for example, on programmes of food
fortification or on protein shortages which could be made up by
52 FOOD WARS

increased meat and dairy production. Despite a successful world-

wide campaign to increase intake of folic acid following the
discovery of its connection with spina bifida (neural tube defect
syndrome), the overall impact of nutritional science in policy-
making has been negligible. Its response to the current epidemic
of heart disease has been ‘health education’ – advice, leaflets and
exhortations to change behaviour – explaining it as caused by
modern lifestyles, rather than by preventable dietary deficiencies.
Almost as soon as the Productionist paradigm was put in
place worldwide in the last half of the 20th century, global cam-
paigns were needed to address the increase in degenerative
diseases. However, the necessary policy instruments were not in
place to tackle the health impact of long-term shifts in diet. The
UN bodies which noted the evidence of new patterns of ill health
were merely intergovernmental bodies who lacked any admini-
strative power and influence to act on the global and national
level. Commercial interests, on the other hand, had no such limits
and could pursue their global ambitions, selling foods and a
lifestyle around the world without regard to their consequences,
and being able to defend their actions as being in the public
interest.
Instead, the developed world now must confront one of the
most challenging food and health disasters ever to face human-
kind: an epidemic of obesity with little prospect of an end in sight
and the prospect of a new wave of diet-related diseases in its
wake. It has little in its armoury with which to combat the causes
of obesity, now affecting significant numbers of children and with
even graver implications for future population health. Health
education is ineffective; consumerism is part of the problem, but
politically it is nearly sacrosanct.
Meanwhile, hunger and insufficiency continue, ironically, to
prevail. As a 1995 FAO review of the global picture starkly put it:
‘[H]unger . . . persists in developing countries at a time when
global food production has evolved to a stage when sufficient
food is produced to meet the needs of every person on the planet.’10
Over-consumption and under-consumption coexist. There is
gross inequality of global distribution and availability of food
energy. The same review asserted that Western Europe, for exam-
ple, has in theory 3500 kcalories available per person per day and
North America has 3600, while sub-Saharan Africa has 2100 and
India has 2200. By 2015 the FAO calculates that 6 per cent of the
 DIET AND HEALTH: DISEASES AND FOOD 53

world’s population (462 million people) will be living in coun-

tries with under 2200 kcalories available per person. And by 2030,
in the most optimistic scenario, in sub-Saharan Africa 15 per cent
of the population will be under-nourished. Numbers of the
under-nourished look set only to decline much more slowly than
suggested by targets, for example those of the World Food Sum-
mit of 1996.11
The transnational nature of these patterns of diet-related
disease demands public policy attention. The enormity of this
human health problem cannot be over-emphasized. Diseases
associated with deficient diet account for 60 per cent of years of
life lost in the established market economies.12
Scientists categorize diseases into two broad groups: com-
municable (carried from person to person or via some intermedi-
ary factor; these include diseases such as malaria, food poisoning,
SARS); non-communicable (acquired by lifestyle or other mis-
match between humans and their environment, such as cardio-
vascular disease and cancers). Figure 2.1 indicates that in the
developed world, deaths through infectious and parasitic dis-
eases are very low compared to developing countries, while diet-
related non-communicable diseases like coronary heart disease
(CHD) and cancers are high in both developed and developing
worlds. Degenerative disease rates are already high in the devel-
oping world. Figure 2.2 gives the leading causes of mortality by
age to give another view of the global disease patterns.
The WHO and the FAO reports stress that world health in
general is in transition with non-communicable diseases now
taking a higher toll than communicable diseases. Figure 2.3
shows the WHO prognosis of how the rates of non-communicable
disease are expected to rise. Factors in this health transition
include diet, demographic change (such as an ageing population)
and cultural factors related to globalization.

THE NUTRITION TRANSITION

In a series of papers, Professor Barry Popkin and his colleagues
have argued that there is what they term a ‘nutrition transition’
occurring in the developing world, associated primarily with
rising wealth.13, 14 The thesis, which has been extensively sup-
54 FOOD WARS

Africa Western Europe The Eastern South- Total

Pacific Americas Mediterranean East world-
Asia wide

Infectious & 5787 794 212 394 959 2968 11,114

parasitic diseases

Cardiovascular 1136 3817 4857 1927 1080 3911 16,728

diseases

Cancers 410 2315 1822 1115 272 1160 7094

Respiratory 1071 511 273 228 365 1393 3841

infections*

Perinatal and 585 371 69 192 371 1183 2771

maternal causes
Injuries 747 1231 803 540 391 1267 4979

* This does NOT include respiratory diseases; includes upper and lower respiratory
infections and otitis media
Source: WHO, Shaping the Future, World Health Report, Geneva, 2003, calculated
from Annex Table 2

Figure 2.1 Number of deaths by WHO regions, estimates for 2002

(thousands)

ported by country and regional studies,15 argues simply that diet-

related ill health previously associated with the affluent West is
now becoming increasingly manifest in developing countries.16,17
The ‘nutrition transition’ suggests shifts in diet from one pattern
to another: for example, from a restricted diet to one that is high
in saturated fat, sugar and refined foods, and low in fibre. This
transition is associated with two other historic processes of
change: the demographic and epidemiological transitions. Demo-
graphically, world populations have shifted from patterns of high
fertility and high mortality to patterns of low fertility and low
mortality. In the epidemiological transition, there is a shift from
a pattern of disease characterized by infections, malnutrition and
episodic famine to a pattern of disease with a high rate of the
chronic and degenerative diseases. This change of disease pattern
is associated with a shift from rural to urban and industrial
lifestyle.
WHO researchers have noted that changes in dietary patterns
can be driven not just by rising income and affluence but also by
the immiseration that accompanies others’ rising wealth;18 low-
 DIET AND HEALTH: DISEASES AND FOOD 55

Leading causes of mortality by age

Adults, 2002

15–59 60 and over

2279 HIV/AIDS 5823 Ischaemic heart disease
1331 Ischaemic heart disease 4692 Cerebrovascular disease
1037 Tuberculosis 2399 Chronic obstruc pulmonary disease
811 Road traffic accidents 1398 Lower respiratory infections
783 Cerebrovascular disease 929 Trachea, bronchus, lung cancers
672 Self-inflicted injuries 754 Diabetes mellitus
475 Violence 735 Hypertensive heart disease
382 Cirrhosis of the liver 606 Stomach cancer
352 Lower respiratory infections 496 Tuberculosis
343 Chronic obstruc pulmonary disease 478 Colon and rectal cancers

Source: WHO, World Health Report 2003

Figure 2.2 Leading causes of mortality, by age, 2002

income countries are experiencing the effects of the transition but

cannot afford to deal with them.19 Popkin argues that, while the
nutrition transition brings greater variety of foods to people who
previously had narrow diets, the resulting health problems from
the shift in diet should not be traded off against the culinary and
experiential gains. Consumers might enjoy the new variety of
foods that greater wealth offers but they are often unaware of the
risk of disease that can follow. The implications of the nutrition
transition now ought to exercise the minds of global as well
national policy-makers: certainly health policy specialists are
concerned at the rise of degenerative diseases in low- and middle-
income countries.20, 21
Nutrition may have recently become a key notion in modern
dietary thinking but it only echoes the insights of an earlier
generation of researchers which included nutrition and public
health pioneers such as Professors Trowell and Burkitt, whose
observations from the 1950s to the 1980s led them to question
‘whether Western influence in Africa, Asia, Central and South
America and the Far East is unnecessarily imposing our diseases
on other populations who are presently relatively free of them’.22
Trowell and Burkitt, both with long medical experience in Africa,
56 FOOD WARS

1990 2020 (baseline scenario)

27 %
22%
43%

49 %

9%

21%
15 %
14%
Communicable diseases, Noncommunicable conditions
maternal and perinatal
conditions and Neuropsychiatric disorders
nutritional deficiencies
Injuries

Source: WHO, Evidence, Information and Policy, 2000

Figure 2.3 Anticipated shift in global burden of disease 1990–2020,

by disease group in developing countries (WHO)

could easily explain the variation in infectious diseases, but not

the variation in rates of non-infectious diseases such as heart
disease between countries at different economic levels of wealth
and development. In Africa in the post-World War II period, they
witnessed the rise of key indicators for diseases such as heart
disease and high blood pressure in peoples who had previously
had little experience of them.23 The dietary transition is swift. An
FAO study of very under-nourished Chinese people (living on
1480 kcalories per day) shows that they derive three-quarters of
their energy intake from starchy staples such as rice, while better-
fed Chinese (living on 2500 kcal per day) are able to reduce their
energy intake from such staples and to diversify their food
sources (see Figures 2.4 and 2.5 which compare the diets of under-
nourished and well-nourished people in China).
Popkin has shown how this same process occurs in both
urban and rural populations in developing countries with rising
incomes. Figures 2.6 and 2.7 show the relationship between per
capita income and what predominantly rural and predominantly
urban populations eat as both get wealthier:24 both eat more
meats and fats, and reduce carbohydrate, as a proportion of their
 DIET AND HEALTH: DISEASES AND FOOD 57

1125 kcal 1375 kcal

from other from
foods starchy
45% staples
55%

Source: National Survey of Income and Expenditure of Urban Households, Govern-

ment of China, 1990; FAO, State of Food Insecurity , 2000, http://www.fao.org
DOCREP/X8200E/x8200e03.htm#P0_0

Figure 2.4 Diet of a well-nourished Chinese adult (2500 kcal/person/

day)

370 kcal
from other
foods
25%

1110 kcal
from
starchy
staples
75%

Source: National Survey of Income and Expenditure of Urban Households, Govern-

ment of China, 1990; http://www.fao.org/DOCREP/X8200E/X8200e03.htm#PO_O

Figure 2.5 Diet of an under-nourished Chinese adult (1480 kcal/

person/day)

overall diet. But there still remain differences between urban and
rural populations, probably due to their different levels of activ-
ity, access to dietary ingredients and cultural mores.25 The more
urban population also consumes more added sugars as it gets
wealthier, whereas the rural population consumes less. Popkin
and his colleagues’ point is that changing economic circum-
stances markedly shape the mix of nutrients in the diet and that
lifestyle factors – such as the degree of urbanization26 and chang-
ing labour patterns – have a major effect on health.
58 FOOD WARS

Annual per capita national Animal Vegetable

(in constant 1993 US$) proteins proteins
10000
Vegetable
7300 fats

6300 Animal Added

fats sugars
4500

2700
Carbohydrates
2200

1700

1300

1000

700

400

200
0 10 20 30 40 50 60 70 80 90 100
Percentage of total

Source: FAO/World Bank/Popkin, B (1998) ‘The Nutrition Transition and its health
implications on lower income countries’, Public Health Nutrition, 1, 5–21

Figure 2.6 Relationship between the proportion of energy from each

food source and GNP per capita, with the proportion of the urban popu-
lation at 25 per cent, 1990

The transition is occurring in areas that usually receive little

food policy attention. A study by the WHO has reported that in
the Middle East changing diets and lifestyles are now resulting
in changing patterns of both mortality and morbidity there too.27
Dietary and health changes can be rapid. In Saudi Arabia, for in-
stance, meat consumption doubled and fat consumption tripled
between the mid-1970s and the early 1990s; in Jordan, there has,
in the same timescale, been a sharp rise in deaths from cardio-
vascular disease. These problems compound older Middle-
Eastern health problems such as protein-energy malnutrition,
especially among children. In China, the national health profile
began to follow a more Western pattern of diet-related disease as
the population gradually urbanized,28 coinciding with an increase
in degenerative diseases. Consumption of legumes such as soya-
bean was replaced by animal protein in the form of meat.
One expert nutritional review of this problem concluded that
 DIET AND HEALTH: DISEASES AND FOOD 59

Animal Vegetable
Annual per capita national income
proteins proteins
(in constant 1993 US$)

10,000

7300

6300

4500 Animal
fats Added
sugars
2700
Carbohydrates
2200
Vegetable
1700
fats
1300

1000

700

400

200
0 10 20 30 40 50 60 70 80 90 100
Percentage of total calories

Source: FAO/World Bank/Popkin, B (1998) ‘The Nutrition Transition and its health
implications on lower income countries’, Public Health Nutrition, 1, 5–21

Figure 2.7 Relationship between the proportion of energy from each

food source and GNP per capita, with the proportion of the urban
population at 75 per cent, 1990

exhorting the Chinese people to consume more soy when they

were voting with their purses to eat more meat would be ineffect-
ive ‘in the context of an increasingly free and global market’.29
Such studies can suggest that the battle to prevent Western
diseases in the developing world appears already to have been
lost. If the nutrition transition is weakening health in China, the
world’s most populous and fastest economically growing nation,
which has 22 per cent of the world’s population but only 7 per
cent of its land, what chance is there for diet-related health
improvements throughout the developing world?
As populations become richer, they substitute cereal foods for
higher-value protein foods such as milk, dairy products and meat,
increased consumption of which is associated with Westerniza-
tion of ill health. Relatively better-off populations also consume
a greater number of non-staple foods and have a more varied, if
not healthier, diet.30 Thus we have the modern nutritional para-
60 FOOD WARS

dox: in the same low-income country there may be ill health

caused by both malnutrition and over-nutrition; in the same rural
area of a poor country both obesity and underweight can coexist.
In policy terms the challenge is whether India, China, Latin
America or Africa, for example, can afford the technical fixes that
the West can resort to in order to improve diet-related health:31
coronary by-pass operations; continuous drug regimes; expens-
ive drugs and foods with presumed health-enhancing bene-
fits;32 and subscriptions to gyms and leisure centres. The affluent
middle classes in the developed world might be able to afford
such fixes but the vast numbers in the developing world certainly
will not. Technical fixes are not societal solutions.
It could be argued that the increase in degenerative diseases
is the inevitable downside of economic progress. The problem for
policy-making is how to differentiate between protecting the
already protective elements of traditional, indigenous diets such
as legumes, fruit and vegetables, and opening up more varied
food markets, which is deemed to be good economic policy. In
practice, too few policy-makers in the developing world have
been prepared to fight to keep ‘good’ elements of national and
local diets or to constrain the flow of Western-style foods and
drinks into their countries lest they infringe support for trade
liberalization. Thus, in stark terms, trade and economic policies
have triumphed over health interests. US-style fast foods – the
‘burgerization’ of food cultures – have been hailed as modernity.
We must now expose the production, marketing and prices of fast
food,33, 34 their nutritional value and their impact on health.35

THREE CATEGORIES OF MALNUTRITION:

UNDERFED, OVERFED AND BADLY FED
More than 2 billion people in the world today have their lives
blighted by nutritional inadequacy. On one hand, half of this
number do not have enough to eat; on the other hand, a growing
army of people exhibit the symptoms of overfeeding and obesity.
In both cases, the international communities are floundering for
solutions, and malnutrition results, as indicated by the following
table.
 DIET AND HEALTH: DISEASES AND FOOD 61

Table 2.2 Types and effects of malnutrition

Type of malnutrition Nutritional effect No. of people affected

globally (× billion)
Hunger deficiency of calories at least 1.2
and protein
Micronutrient deficiency deficiency of vitamins 2.0–3.5
and minerals
Over-consumption excess of calories, at least 1.2–1.7
often accompanied by
deficiency of vitamins
and minerals
Source: Gardner and Halweil (2000), based on WHO, IFPRI, ACC/SCN data36

Figure 2.8 highlights the role of the mother in infant health. Even
before conception, the mother’s own nutrition is vital.37 It is now
understood that children who are born with a low birthweight
are at increased risk of developing heart disease and that good
nourishment of the foetus is key. That nutrition affects disease
patterns and life expectancy is now well documented.38
One of the particularly tragic consequences of under-
nourishment is its impact on the world’s children. UNICEF
calculates that 800 million children worldwide suffer malnutri-
tion at any given time (Figure 2.9 gives the FAO’s estimated
locations of these millions. Table 2.3 then gives the sobering
projections for 2015 and 2030.) High proportions of Asian and
African mothers are under-nourished, largely due to seasonal
food shortages, especially in Africa. About 243 million adults
in developing countries are deemed to be severely under-
nourished.39 This type of adult under-nutrition can impair work
capacity and lower resistance to infection.
Against a rapid growth in world population, well-informed
observers agree that greater food production is needed for the
future.40, 41, 42, 43 One estimate suggests that by 2020 there will be
1 billion young people growing up with impaired mental devel-
opment due to poor nutrition. At a conservative estimate, this
means there will 40 million young people added to the total each
year.44
62 FOOD WARS

Higher Impaired
mortality rate mental
development Increased
risk of adult
chronic
Reduced capacity
Baby disease
Elderly to care for baby
Malnourished Low birth
weight Untimely / inadequate
weaning
Frequent
Inadequate infection
Inadequate
foetal catch up Inadequate
Inadequate food, health
nutrition growth
food, & care
health &
care
Child
Stunted
Woman Reduced
Malnourishe mental
Pregnancy capacity
Low weight gain
Adolescent Inadequate
Stunted food, health
& care

Higher Reduced
maternal Inadequate
food, health & mental
mortality capacity
care

Source: ACC/SCN (2000) Nutrition through the Life Cycle: 4th Report on the World
Nutrition Situation, New York: UN Administrative Committee on Co-ordination, Sub-
committee on Nutrition, p8

Figure 2.8 Life cycle – the proposed causal links

China Sub-Saharan Africa

140 186

Near East and

North Africa
36
India
208 Latin America and
Caribbean
55
Other Asia and
Pacific
167

Source: State of Food Insecurity in the World 2000, http://www.fao.org/DOCREP/

X8200E/x8200e03.htm#P0_0

Figure 2.9 Number of under-nourished by region, 1996–1998, millions

 DIET AND HEALTH: DISEASES AND FOOD 63

Table 2.3 Projected trends in under-nourishment by region, 1996–

2030

1996–98 2015 2030 1996–98 2015 2030

Per cent of population Millions of people
Sub-Saharan Africa 34 22 15 186 184 165
Near East/North Africa 10 8 6 36 38 35
Latin America and the 11 7 5 55 45 32
Caribbean
China and India 16 7 3 348 195 98
Other Asia 19 10 5 166 114 70
Developing countries 18 10 6 791 576 400
Source: FAO (2000) Agriculture: Towards 2015/30, Technical Interim Report, April,
Rome, FAO, www.fao.org

THE OBESITY EPIDEMIC

As early as 1948, there were medical international groups
researching the incidence of obesity in various countries.45 There
were official reports at country level by the early 1980s,46 and
there has also been a commercial and consumer response to
obesity for even longer.47 But the grip of international obesity was
in fact confirmed by the WHO’s Task Force on Obesity in 1998.
Today, overweight and obesity are key risk factors for chronic
and non-communicable diseases.48 In developing countries obes-
ity is more common amongst people of higher socio-economic
status and in those living in urban communities. In more affluent
countries, it is associated with lower socio-economic status,
especially amongst women and rural communities.49 Historically
and biologically, weight gain and fat storage have been indicators
of health and prosperity. Only the rich could afford to get fat. By
2000, the WHO was expressing alarm that more than 300 million
people were defined as obese, with 750 million overweight, ie
pre-obese: over a billion people deemed overweight or obese
globally.50 But by 2003, this figure had been radically revised
upwards when the International Association for the Study of
Obesity (the IASO) calculated that up to 1.7 billion people were
now overweight or obese. The new figures were in part due to
more accurate statistics but also to the recalculation of obesity
benchmarks, which acknowledged rising obesity in Asia. 51
64 FOOD WARS

Particularly worrying is that extreme degrees of obesity are rising

even faster than the overall epidemic: in 2003, 6.3 per cent of US
women, that is one in sixteen, were morbidly obese, with a body
mass index of 40 or more.
Obesity is defined as an excessively high amount of body fat
or adipose tissue in relation to lean body mass. Standards can be
determined in several ways, notably by calculating population
averages or by a mathematical formula known as ‘body mass
index’ (BMI),52 a simple index of weight-for-height: a person’s
weight (in kilos) divided by the square of the height in metres
(kg/m2). BMI provides, in the words of the WHO, ‘the most
useful, albeit crude, population-level measure of obesity’. A
personal BMI of between 25 and 29.9 is considered overweight;
‘obesity’ means a BMI of 30 and above; a personal BMI of less
than 17 is considered underweight. There is some argument
about whether the definition of overweight (a BMI within the 25–
29.9 range) should be lowered from 25 to 23, in which case tens
of millions more people would be considered overweight, and
such an unofficial re-classification has led to the disparity be-
tween current world obesity figures.
BMI levels are a useful predictor of risk from degenerative
diseases. Unutilized food energy is stored as fat. Currently, the
US National Institutes of Health consider that all adults (aged 18
years or older) who have a BMI of 25 or more are at risk from
premature death and disability as a consequence of overweight
and obesity.53 Men are at risk who have a waist measurement
greater than 40 inches (102 cm); women are at risk who have a
waist measurement greater than 35 inches (88 cm). Whilst height
is obviously also taken into consideration, we should regard
these measurements as key health benchmarks.
Figure 2.10 shows how, in a remarkably short time, the rate
of obesity within countries is rising. In the UK, for instance,
between 1980 and 2000, obesity trebled from 7 per cent of the
population to 21 per cent.54 Particularly alarming is that the
‘North Americanization’ of obesity is spreading down Latin
America.55 Figure 2.11 illustrates the level of obesity in compari-
son to underweight in developed and developing countries. In
many countries, levels of obesity are double what they were 15
years ago.56 In Peru, Tunisia, Colombia, Brazil, Costa Rica, Cuba,
Chile, Mexico and Ghana, for example, overweight adults out-
number those who are thin. Even Ethiopia and India, tradition-
 DIET AND HEALTH: DISEASES AND FOOD 65

30.0

26.0
22.6
21.0
20.8
20.0

17.0
Per cent

14.6

14.5
14.2

14.0
13.2
12.9
11.2

11.2

11.1
9.6
9.3
8.7

8.7
8.6

8.4
10.0

7.7
7.6

7.4

7.1
7.0

7.0
6.8

6.5
6.1
5.5

5.5
5.3

5.1
2.9
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ni
U

Source: OECD Health Data 2002, http://www.oecd.org/pdf/M00031000/M00031130.pdf

Figure 2.10 Obesity in adult population across OECD countries

ally beset by under-nutrition57 and starvation now have the

added burden of an emerging obesity problem. The trend to
obesity is occurring in countries with different economic profiles,
from the Asian ‘Tiger’ economies to the oil-rich Middle East.58
Rising obesity rates among children are particularly troubling
to health professionals, as this trend suggests massive problems
of degenerative disease for the future. In Jamaica and Chile, for
instance, one in ten children is obese; in Japan, a country historic-
ally with a very low incidence of fat in its diet and with a low
incidence of obesity, the frequency of obesity in school children
has increased from 5 per cent to 9 per cent for girls and 10 per cent
for boys in 1996.59 (Table 2.4 summarizes the rapid rise in obesity
as measured by comparing initial surveys with follow-up world-
wide studies. The final column of the table shows how obesity is
becoming out of control in developed and developing countries
alike.) Even in Australia, obesity rose 3.4-fold for boys and 4.6-
fold for girls between 1985 and 1995; in Egypt, 3.9-fold between
1978 and 1996; in Morocco, 2.5-fold in just five years, from 1987
66 FOOD WARS

350

302.1 BMI < 17.00

300
BMI > = 30.00
Population affected (millions)

250
214.8
200
169.6

150 131.5
117.1
100

47.1
50 28.2
5.6 6.7 10.2
0
Global Least developed Developing countries Economies in Developed market
countries (45) (75) transition (27) economy countries
(24)

Source: WHO, Nutrition for Health and Development: A Global Agenda for Combating
Malnutrition, 2000, http://www.who.int/nut/db_bmi.htm

Figure 2.11 Global population affected by underweight and obesity

in adults, by level of development, 2000

to 1992; in Scotland by 2.3-fold for boys and 1.8-fold for girls

between 1984 and 1994. A child’s weight can be thrown off
balance by a daily consumption of only one sugar-sweetened soft
drink of 120 kcals; over ten years, this intake would turn into
50kg of excess growth. Although their review also fully acknow-
ledged the role of genetics, the authors pointed to pressures on
children’s diets from advertisements to help explain the rapidity
of consumption and obesity changes.60
Health education seems to be powerless before this rising tide
of obesity. On the island of Mauritius, for instance, a study which
examined adults over a period of five years found that, despite a
national programme promoting healthy eating and increased
physical activity, obesity levels had increased dramatically:61 men
with a BMI above 25 increased from 26.1 per cent to 35.7 per cent
and for women the figure grew from 37.9 per cent to 47.7 per cent
during the five-year study. The government of Mauritius con-
cluded that a National Nutrition Policy and National Plan of
Action on Nutrition was needed.62 Even in the US, the homeland
of fast food, President George W Bush was so alarmed by the
obesity crisis that in 2002 he launched a national debate. He has
long had good reason for concern,63 as even as far back as 1986,
 DIET AND HEALTH: DISEASES AND FOOD 67

Table 2.4 Global increases in the prevalence of childhood obesity1

Country Index of Age of Date of first Date of second Growth of

measurement children study (% study (% obesity
obesity) obesity) incidence
from first
to second
study
USA2 BMI=95th 6–11 1971/74 (4%) 1999 (13%) Up 3.3-
fold
percentile 12–19 1971/74 (6%) 1999 (14%) Up 2.3-
fold
England3 Age-adjusted 4–11 1984 (0.6% 1994 (1.7% boys; Up 2.8-
BMI cut-off boys; 1.3% 2.6% girls) fold (boys)
linked to adult girls) Up 2.0-
value of 30 kg/m2 fold (girls)

Scotland3 Age-adjusted 4–11 1984 (0.9% 1994 (2.1% Up 2.3-

BMI cut-off boys; 1.8% boys; 3.2% fold (boys)
linked to adult girls) girls) Up 1.8-fold
value of 30 kg/m2 (girls)
China4 Age-adjusted 6–9 1991 (10.5%) 1997 (11.3%) Up 1.1-fold
BMI cut-off
linked to adult 10–18 1991 (4.5%) 1997 (6.2%) Up 1.4-fold
value of
25 kg/m2
Japan5 ≥120% of 10 1970 (<4 1996 Up 2.5-
standard boys; ≈4% (≈10% boys; fold (boys)
weight girls) ≈9% girls) Up 2.3-
fold (girls)
Egypt6 Weight-for- 0–5 1978 (2.2%) 1996 (8.6%) Up 3.9-
height >2 SD fold
from median
Australia7 Age-adjusted 7–15 1985 (1.4% 1995 (4.7% Up 3.4-
BMI cut-off boys; 1.2% boys; 5.5% fold (boys)
linked to adult girls) girls) Up 4.6-
value of 30 kg/m2 fold (girls)
Ghana6 Weight-for- 0–3 1988 (0.5%) 1993/94 (1.9%) Up 3.8-
height >2 SD fold
from median
Morocco6 Weight-for- 0–5 1987 (2.7%) 1992 (6.8%) Up 2.5-
height >2 SD fold
from median
Brazil4 Age-adjusted 6–9 1974 (4.9%) 1997 (17.4%) Up 3.6-
BMI cut-off fold
68 FOOD WARS

Table 2.4 (Continued)

Country Index of Age of Date of first Date of second Growth of

measurement children study (% study (% obesity
obesity) obesity) incidence
from first
to second
study
linked to adult 10–18 1974 (3.7%) 1997 (2.6%) Up 3.4-
value of fold
25 kg/m2
Chile8 Weight-for- 0–6 1985 (4.6%) 1995 (7.2%) Up 1.6-fold
height >2 SD
from median
Costa Weight-for- 0–6 1982 (2.3%) 1996 (6.2%) Up 2.7-fold
Rica6 height >2 SD (1982)
from median 1–7
(1996)
Haiti6 Weight-for- 0–5 1978 (0.8%) 1994/95 (2.8%) Up 3.5-
height >2 SD fold
from median
Sources: 1 Ebbeling, CB, Pawlak, DB and Ludwig, DS (2002) ‘Childhood obesity:
public-health crisis, common sense cure’, The Lancet, 360, 10 August, 473–482; 2
National Center for Health Statistics (1999) Prevalence of overweight among children
and adolescents: United States, 1999–2000, available at www.cdc.gov/nchs/
products/pubs/pubd/hestats/overweight99.htm (accessed 29 January 2002); 3 Chinn,
S and Rona, RJ (2001) ‘Prevalence and trends in overweight and obesity in three
cross-sectional studies of British children, 1974–94’, BMJ, 322, 24–26; 4 Wang, Y,
Monteiro, C and Popkin, BM (2002) ‘Trends of obesity and underweight in older
children and adolescents in the US, Brazil, China, and Russia’, Am J Clin Nutr, 75,
971–977; 5 Murata, M (2000) ‘Secular trends in growth and changes in eating patterns
of Japanese children’, Am J Clin Nutr, 72 (suppl), 1379S–1383S; 6 deOnis, M and
Blossner, M (2000) ‘Prevalence and trends of overweight among preschool children
in developing countries’, Am J Clin Nutr, 72, 1032–1039; 7 Magarey, Am, Daniels, LA
and Boulton, TJC (2001) ‘Prevalence of overweight and obesity in Australian children
and adolescents: reassessment of 1985 and 1995 data against new standard
international definitions’, Med J Aust, 174, 561–564; 8 Filozof, C, Gonzalez, C, Sereday,
M, Mazza, C and Braguinsky, J (2001) ‘Obesity prevalence and trends in Latin
American countries’, Obes Rev, 2, 99–106.

the economic costs of illness associated with overweight in the

US were estimated to be $39 billion; today the estimated cost of
obesity and overweight is about $117 billion.64 The rise in US
obesity is dramatic: between 1991 and 2001, adult obesity in-
creased by 74 per cent. The percentage of US children and adole-
scents who are defined as overweight has more than doubled
 DIET AND HEALTH: DISEASES AND FOOD 69

since the early 1970s, and about 13 per cent of children and
adolescents are now seriously overweight.65 These general US
figures disguise marked differences between ethnic groups and
income levels: according to the Centers for Disease Control and
Prevention, 27 per cent of black and about 21 per cent of His-
panics of all ages are considered obese – that is, a third over-
weight – compared with a still worrying but lower 17 per cent
among whites.66 The poor are more obese than the more affluent
within the US. The price of food is a key driver of obesity: satur-
ated fats from dairy and meat and hydrogenated (trans) fats are
relatively cheap.67
The connection between overweight and health risk is alarm-
ingly highlighted by the following list of the physical ailments
that an overweight population (with a BMI higher than 25) is at
risk of:68

l high blood pressure, hypertension;

l high blood cholesterol, dyslipidemia;
l type-2 (non-insulin-dependent) diabetes;
l insulin resistance, glucose intolerance;
l hyperinsulinemia;
l coronary heart disease;
l angina pectoris;
l congestive heart failure;
l stroke;
l gallstones;
l cholescystitis and cholelithiasis;
l gout;
l osteoarthritis;
l obstructive sleep apnea and respiratory problems;
l some types of cancer (such as endometrial, breast, prostate
and colon);
l complications of pregnancy;
l poor female reproductive health (such as menstrual irregu-
larities, infertility and irregular ovulation);
l bladder control problems (such as stress incontinence);
l uric acid nephrolithiasis;
l psychological disorders (such as depression, eating disorders,
distorted body image, and low self esteem).
70 FOOD WARS

There is a vocal position – particularly articulated in the US –

arguing that the critique of obesity is an infringement of personal
liberty and ‘size-ist’, making cultural value statements. If some-
one wants to be fat and is content and loved by others, goes this
argument, what does it matter? The list of health problems given
above is surely an answer to this position. The costs of what is
presented as an ‘individual’ problem are, in fact, society wide.
The ill-health that results is paid for either in direct costs or in a
societal drag – lost opportunities, inequalities and lost effi-
ciencies. This is why policy-makers have to get to grips with
obesity and the world’s weight problem.
Both obesity and overweight are preventable. At present the
debate about obesity is divided about which of three broad
strategies of action is the best to address. One strand argues that
it is a problem caused by over-consumption (diet and the types
of food) and over-supply; another that it is lack of physical
activity; and the third that there might be a matter of genetic
predisposition. Certainly, the emphasis has to be on changing the
environmental determinants that allow obesity to happen. A
pioneering analysis by Australian researchers in the mid-1990s
proposed that the obesity pandemic could only be explained in
‘ecological’ terms: Professors Garry Egger and Boyd Swinburn
set out environmental determinants such as transport, pricing
and supply; they claimed that environmental factors were so
powerful in upsetting energy balances that obesity could be
viewed as ‘a normal response to an abnormal environment’.69 So
finely balanced are caloric intake and physical activity than even
slight alterations in their levels can lead to weight gain. Swinburn
and Egger assert that no amount of individual exhortation will
reduce worldwide obesity;70, 71 transport, neighbourhood layout,
home environments, fiscal policies and other alterations of sup-
ply chains must be tackled instead.

CALCULATING THE BURDEN OF

DIET-RELATED DISEASE
During the 1990s, world attention was given to calculating the
costs of what has been called the ‘burden of disease’. Five of the
ten leading causes of death in the world’s most economically
 DIET AND HEALTH: DISEASES AND FOOD 71

advanced country, the US, were, by the 1980s, diet-related: coro-

nary heart disease, some types of cancer, stroke, diabetes mellitus
and atherosclerosis. Another three – cirrhosis of the liver, acci-
dents and suicides – were associated with excessive alcohol
intake.72 Together these diseases were accounting for nearly 1.5
million of the 2.1 million annual deaths in the US. Only two
categories in the top ten – chronic obstructive lung disease and
pneumonia and influenza – had no food connection.
In a 1990s study published by the World Bank, ‘The Global
Burden of Disease’,73 the authors Murray and Lopez gave a
detailed review of causes of mortality in eight regions of the world.
Ischaemic heart disease accounted for 6.26 million deaths. Of
these, 2.7 million were in established market economies and form-
erly socialist economies of Europe; 3.6 million were in developing
countries (out of 50.5 million deaths from all causes in 1990).
Stroke was the next most common cause of death (4.38 million
deaths, almost 3 million in developing countries), closely followed
by acute respiratory infections (4.3 million, 3.9 million in devel-
oping countries). Other leading causes of death include diar-
rhoeal disease (almost totally occurring in developing countries),
chronic obstructive pulmonary disease, tuberculosis, measles,
low birthweight, road-traffic accidents and lung cancer, with only
diarrhoea and low birthweight having a diet-related aetiology.
They also calculated that cancers caused about 6 million deaths
in 1990. About 2.4 million cancer deaths occurred in established
market economies and former socialist economies of Europe. By
1990, therefore, there were already 50 per cent more cancer deaths
in less developed countries than in developed countries.
For their analysis, Murray and Lopez created a new index
they called the DALY, standing for the ‘disability adjusted life
year’. A DALY is the sum of life years lost owing to premature
death, and years lived with disability (adjusted for severity). It
is thus a measure of both death and disability (both mortality and
morbidity). The top ten DALYs in all developing regions com-
bined already included ischaemic heart disease and cerebovas-
cular disease. Murray and Lopez’s report concluded: ‘Clearly, the
focus of research and debate about health policy in developing
regions should address the current challenges presented by the
epidemiological transition now, rather than several decades
hence.’ Table 2.5 gives their original breakdown for the world of
the DALYs by main disease, present and anticipated.
72 FOOD WARS

Table 2.5 DALYs lost by cause, for the developed and developing
countries, 1990 and 2020

Cause Developed Developing

1990 2020 1990 2020
(%) (%) (%) (%)
Infectious diseases 7.8 4.3 48.7 22.2
Cardiovascular disease 20.4 22.0 8.3 13.8
Coronary heart disease 9.9 11.2 2.5 5.2
Stroke 5.9 6.2 2.4 4.2
Diabetes 1.9 1.5 0.7 0.7
Cancer 13.7 16.8 4.0 9.0
Neuropsychiatric disorders 22.0 21.8 9.0 13.7
Injuries 14.5 13.0 15.2 21.1
Source: Murray, CJL and Lopez, AD (1996) The Global Burden of Disease: A Compre-
hensive Assessment of Mortality and Disability from Diseases, Injuries and Risk
Factors in 1990 and Projected to 2020, Cambridge, MA: Harvard University Press on
behalf of the World Bank and WHO

The authors anticipated that the greatest increase in cardiovas-

cular disease-related DALYs would occur in developing coun-
tries, up 8.3 per cent in 1990 to 13.8 per cent in 2020 – a rising
burden of disease for those countries which could least afford it.
The corresponding increase in developed countries’ DALYs
associated with non-communicable diseases was calculated to be
only relatively slight, rising from 20.4 per cent to 22.0 per cent.
(The developed world already had a high base rate of DALYs
from diet-related disease). (Interestingly, there is hardly any
movement in diabetes figures for developing countries and a fall
for developed countries, yet it should be noted that diabetes
figures are in fact rising rapidly worldwide. The newness of this
diet-related epidemic might have been too late for Murray and
Lopez’s 1990 data.)
One purpose of the DALY method is to enable policy-makers
to estimate the relative risk of major factors for health. Table 2.6
gives the Swedish National Institute of Public Health’s summary
of the calculated impacts of smoking, alcohol, diet and physical
activity for key DALYs in the EU and Australia. Again, the diet-
related disease toll is very high. Smoking, as was noted at the
start of this chapter, is a major contributory factor in heart disease
but the dietary factors, when separated, were almost as great.
 DIET AND HEALTH: DISEASES AND FOOD 73

Table 2.6 DALYs lost by selected causes, for the EU and Australia,
around 1995

Cause EU % Australia %
Smoking 9.0 9.5
Alcohol consumption 8.4 2.1
Diet and physical activity 8.3 16.4
Overweight 3.7 2.4
Low fruit and vegetable intake 3.5 2.7
High saturated fat intake 1.1 2.6
Physical inactivity 1.4 6.8
Sources: National Institute of Public Health, Stockholm (1997)74, 75

The DALY approach was extended in the ‘World Health

Report 2002’ which was based on a series of massive multi-
country studies designed to test and refine the methodology.
Figure 2.12 details risk factors by level of development. The
results, however, merely deepened the insights from the earlier
study. If anything, the burden of diet-related disease and of lack
of physical activity received even higher profile. Special studies
on the impact of lack of fruit and vegetables in the diet showed
great impact. The WHO–FAO 2003 report underlined how a
variety of diseases, from heart disease to diabetes, were all
associated with the same dietary pattern: over-consumption,
excess fat, under-consumption of fruit and vegetables and excess
added sugar and salt.76

The financial costs

In 2001, the Commission on Macroeconomics and Health, created

by the WHO, argued that there were mutual benefits to be had
from improved health and for the economy, particularly for those
in low-income countries.77 Table 2.7 shows how general health
care costs are rising rapidly in many developed economies; in the
developing world, the costs of health care for degenerative dis-
eases are now also looming as a serious concern. The growth of
health expenditure is sometimes higher than the growth of gross
domestic product (GDP). Table 2.8 gives a breakdown of the
direct and indirect costs for a number of key diet-related diseases
in the US; these costs are immense, even for such a rich society.
74 FOOD WARS

Developing countries – high mortality

1234567890123456789012345678901212345678901234567 12345
Underweight 1234567890123456789012345678901212345678901234567
1234567890123456789012345678901212345678901234567 12345
Unsafe sex 1234567890123456789012345678901212345
1234567890123456789012345678901212345
1234567890123456789012345678901212345
Unsafe water, sanitation and hygiene 123456789012345678901
123456789012345678901
123456789012345678901
123
Indoor smoke from solid fuels 1234567890123
123
1234567890123
Zinc deficiency 1234567890123
1234567890123
1234
Iron deficiency 1234
1234567890 12
Viamin A deficiency 1234567890 12
Blood pressure 1234567890
1234567890
1234 12
Tobacco 1234
1234 12
12345678
Cholesterol 12345678
12345678
0% 2% 4% 6% 8% 10% 12% 14% 16%

Attributable DALYs (% of total 833 million DALYs)

Developing countries – low mortality
1234
1234
1234
GROUP I. Communicable diseases,
Alcohol maternal and perinatal conditions
1234567890123456789
1234567890123456789
Blood pressure 1234567890123456789 123
and nutritional deficiencies
123456 1234 123Infectious and parasitic diseases
123456 1234
1234 123
Tobacco 123456 Maternal and perinatal conditions
123Nutritional deficiencies
1234
123456789
123456789
1234
Underweight
12345
1234567
12345
Overweight 1234567 123
GROUP II. Noncommunicable conditions
123Cardiovascular diseases
123456789
Cholesterol 123456789 Cancers
123456 123
123Chronic respiratory diseases
123456
Low fruit and vegetable intake 123456
1234
12345
1234
12345
Neuropsychiatric disorders
Indoor smoke from solid fuels 12345 1234 Other noncommunicable conditions

1234
1234
Iron deficiency GROUP III. Injuries
1234567
Unsafe water, sanitation and hygiene 1234567 Unintentional injuries
Intentional injuries

0% 2% 4% 6% 8% 10% 12% 14% 16%

Attributable DALYs (% of total 408 million DALYs)

Developed countries
123456789012345678901 1234567
123456789012345678901
Tobacco 123456789012345678901
1234567
1234567
123456789012345678901234567890121234567890123
123456789012345678901234567890121234567890123
Blood pressure 123456789012345678901234567890121234567890123
12
Alcohol 12
12345678901234567890123456789012
Cholesterol12345678901234567890123456789012
12345678901234567890112
123456789
Overweight 12345678901234567890112
123456789
12345678901234
Low fruit and vegetable intake 12345678901234
12345678901 12
Physical inactivity12345678901 12
123
Illicit drugs 123
1234
Unsafe sex 1234

Iron deficiency
12
0% 2% 4% 6% 8% 10% 12% 14% 16%

Attributable DALYs (% of total 214 million DALYs)

Source: The World Health Report 2002

Figure 2.12 Burden of disease attributable to ten selected leading risk
factors, by level of development and type of affected outcome
 DIET AND HEALTH: DISEASES AND FOOD 75

Health ministries, it appears, are locked in a model which

tends to be curative rather than preventative. The UK health care
system, for instance, costs £68 billion for around 60 million
people, costs that are anticipated to rise to between £154 billion
($231 billion) and £184 billion ($276 billion) by 2022–2023 in 2002
prices.79 In other words, at constant prices, UK health care costs
are doubling.
In the context of diet-related disease, the direct and indirect
financial tolls of ill health could offer opportunities for positive
policy intervention through a health-enhancing food supply
chain. An estimate for the UK by the Oxford University British
Heart Foundation Health Promotion Research Group has calcu-
lated that coronary heart disease (CHD) – constituting about half
of all cases of cardiovascular disease – costs the UK £10 billion
per annum. These costs are made up of £1.6 billion in direct costs
(primarily to the taxpayer through the costs of treatment by the
NHS) and £8.4 billion in indirect costs to industry and to society
as a whole, though loss of productivity due to death and disa-
bility.80 (This is probably an underestimate of the direct costs to
the UK’s National Health Service as these costs do not include the
cancer treatment costs.)
A report chaired in 2002 by Derek Wanless, a former head of
the NatWest Bank, for the Chancellor of the Exchequer produced
not dissimilar calculations.81 It estimated that costs for the health
service will rise alarmingly if targets are not met to reduce CHD
and cancers. CHD treatment costs (drugs like statins and surgical
techniques like re-vascularisation) would add an additional £2.4
billion per annum by 2010–11, doubling CHD expenditure. Such
calculations remind us of the multi-headed nature of ill health.
Smoking, diet, physical activity, genetics, environment and socio-
economic background all have direct health outcomes. Wanless
and his team were convinced by US scientific work that high
cholesterol – ‘which is mainly due to diet’ – accounts for 43 per
cent of CHD incidence, compared to 20 per cent for smoking. This
sort of evidence shows that the poor diet has such far-reaching
financial implications that it warrants higher political attention.
This case was confirmed by a second Wanless study arguing for
the economic value of facing the public health costs of poor diet,
lifestyle and education.82 However, for the last quarter of a cen-
tury policy attention has been directed to cutting costs, not by
altering the food supply chain, but by such policies as contracting
76 FOOD WARS

Table 2.7 Growth of expenditure on health, 1990–2000

Real per capita growth Health spending as

rates, 1990–2000 (%) per cent of GDP
Health spending GDP 1990 1998 2000

Australia 3.1 2.4 7.8 8.5 8.3

Austria 3.1 1.8 7.1 8.0 8.0
Belgium 3.5 1.8 7.4 8.5 8.7
Canada 1.8 1.7 9.0 9.1 9.1
Czech Republic 3.9 0.1 5.0 7.1 7.2
Denmark 1.7 1.9 8.5 8.4 8.3
Finland 0.1 1.8 7.9 6.9 6.6
France 2.3 1.4 8.6 9.3 9.5
Germany 2.2 0.2 8.7 10.6 10.6
Greece 2.8 1.9 7.5 8.7 8.3
Hungary (a) 2.0 2.7 7.1 6.9 6.8
Iceland 2.9 1.6 7.9 8.3 8.9
Ireland 6.6 6.4 6.6 6.8 6.7
Italy 1.4 1.4 8.0 7.7 8.1
Japan 3.9 1.1 5.9 7.1 7.8
Korea 7.4 5.1 4.8 5.1 5.9
Luxembourg (b) 3.7 4.5 6.1 5.8 6.0
Mexico 3.7 1.6 4.4 5.3 5.4
Netherlands 2.4 2.3 8.0 8.1 8.1
New Zealand 2.9 1.5 6.9 7.9 8.0
Norway 3.5 2.8 7.8 8.5 7.5
Poland (b) 4.8 3.5 5.3 6.4 6.2
Portugal 5.3 2.4 6.2 8.3 8.2
Slovak Republic .. 4.0 .. 5.9 5.9
Spain 3.9 2.4 6.6 7.6 7.7
Switzerland 2.5 0.2 8.5 10.6 10.7
United Kingdom 3.8 1.9 6.0 6.8 7.3
United States 3.2 2.3 11.9 12.9 13.0
OECD Average (c,d) 3.3 2.2 7.2 8.0 8.0
EU Average 3.1 2.3 7.4 8.0 8.0
Source: OECD (2002) Health Data 2002, www.oecd.org/pdf/M00031000/M000
31130.pdf (p1). (a) Hungary: 1991–2000. (b) Luxembourg and Poland: 1990–1999. (c)
OECD averages exclude the Slovak Republic because of missing 1990 estimates. (d)
Unweighted averages.
Note: No recent estimates are available for Sweden and Turkey.
 DIET AND HEALTH: DISEASES AND FOOD 77

Table 2.8 Economic costs of diet- and exercise-related health prob-

lems, US

Disease Direct costs US$ Indirect costs US$ Total costs

billion (medical billion (productivity US$ billion
expenditures) losses)
Heart disease 97.9 77.4 175.3
Stroke 28.3 15.0 43.3
Arthritis 20.9 62.9 83.8
Osteoporosis n.a. 14.9 14.9
Breast cancer 8.3 7.8 16.1
Colon cancer 8.1 n.a. 8.1
Prostate cancer 5.9 n.a. 5.9
Gall bladder disease 6.7 0.6 7.3
Diabetes 45.0 55.0 100.0
Obesity 55.7 51.4 107.1
Total = 561.8
Sources: National Institutes of Health (1998) and Wolf and Colditz (1998)78
Note: Costs are expressed in constant 1998 dollars, using the Consumer Price Index.

out services and by privatization. In the UK, less than £5 million

a year is spent on food-related health education. Meanwhile,
drug companies and surgeons only offer expensive but highly
sophisticated solutions when the patient is already sick.
Indeed, drug treatments can be hugely expensive. A trial on
over 20,000 UK people with high risks for heart disease showed
that giving patients a type of drug known as statins reduced the
risk of a first coronary attack by 25 per cent but would cost £1
($1.5 or €1.5) per patient per day.83 Currently, 1.8 million people
are prescribed statins, costing UK£750 million a year. Taking
statins for three years can reduce the risk of a heart attack by up
to a third.

Coronary heart disease (CHD)

Since 1999, the WHO has attributed 30 per cent of all annual
global deaths – that is, of 15 million people – to cardiovascular
disease.84, 85 The majority of those deaths are in low- and middle-
income countries. In 1998, 86 per cent of DALYs were lost to
cardiovascular disease worldwide.
78 FOOD WARS

The main risk factors for heart disease are high blood pres-
sure, smoking and lipid concentrations (cholesterol levels).
Others include age, sex, family history and the presence of
diabetes. WHO recommendations for reducing CVD include:86

l regular physical activity

l linoleic acid
l fish and fish oils
l vegetables and fruits, including berries
l potassium
l low to moderate alcohol intake.

The WHO judges that there is convincing evidence for the in-
creasing risks from:

l myristic and palmitic acids

l trans-fatty acids
l high sodium intake
l overweight
l high alcohol intake.

In regard to CHD, public health policy has tended to focus on two

things: health education as prevention, and improved medical
treatment through drug, hospital and surgical care. It has also
urged behavioural change, in particular a reduction of total fat
intake and especially of saturated fats (mainly from animal meat
and dairy fats). This health promotion policy has had an effect:
rates of heart disease are declining in most affluent Western
countries, after years of steady increase since the immediate post-
World War II period (see Tables 2.9 and 2.10).87
The global picture is more complex, however.88 For example,
the steep rise in CHD in the newly independent countries of
Eastern Europe (such as Belarus, Azerbaijan and Hungary) is
worrying. Leaving the strictures of the Soviet era means only that
already high rates of CHD have risen further. Even in countries
considered to have a healthy diet, like Greece and Japan, social
change is being accompanied by changing patterns of diet-
related disease: Greece’s CHD and obesity rates are rising as it
changes to a more Northern European diet high in animal fats,
following entry to the European Union and increased tourism.
 DIET AND HEALTH: DISEASES AND FOOD 79

Table 2.9 Age-standardized deaths per 100,000 population from

CHD selected countries, 1968–1996: men

Men 1968 1978 1988 1998

Finland 718 664 477 340
UK 517 546 434 297
Austria 327 349 262 226
US 694 504 292 224
Australia 674 409 315 202
Canada 543 457 296 200
Italy* 230 249 172 150
Belgium* 345 313 184 147
Spain 99 165 146 125
France 152 154 118 92
Japan 92 74 52 58
Note: *latest statistics for 1994

Table 2.10 Age-standardized deaths per 100,000 population from

CHD selected countries, 1968–1996: women

Women 1968 1978 1988 1996

UK 175 182 156 107
Finland 204 177 141 93
US 273 185 119 92
Austria 120 119 84 81
Australia 268 186 117 73
Canada 198 155 100 72
Belgium* 111 100 61 46
Italy* 87 82 51 43
Spain 33 46 39 34
France 49 44 30 22
Japan 45 99 21 21
Note: *latest statistics for 1994
Source: British Heart Foundation from WHO country statistics

Death rates from CHD may have dropped in the US and Finland,
but it should be remembered that their morbidity and costs
are still high, as was shown by the Global Burden of Disease
studies.
This complexity keeps epidemiologists busy around the
world, but the rapidity of change should bring little surprise. In
80 FOOD WARS

1981 Trowell summarized the emergence of CHD amongst East

Africans: in the 1930s, he reported, autopsies had shown zero
CHD in East Africa, and only one case among 2994 autopsies
conducted in Makere University Medical School over the period
1931–1946. However, by the 1960s CHD in this region was emerg-
ing as a major rather than peripheral health problem.89
In China, between 1991 and 1995,90 CHD accounted for 15 per
cent of all deaths. Cholesterol levels here, compared to those
found in Western populations, were low but were increasing
rapidly among the urban populations where a more affluent
lifestyle was being adopted. Daily intake of meat, eggs and
cooking oil had increased while intake of legumes and cereals
had decreased. A reduction in the consumption of Western fast
foods was also recommended as were increasing physical activ-
ity levels, an urging which could be applied to many urbanizing
developing countries.

Food-related cancers

Since the 1980s, dietary factors have been thought to account for
around 30 per cent of cancers in Western countries, making diet
second only to tobacco as a preventable cause of cancer;91 in
developing countries diet accounted for around 20 per cent.92
Table 2.11 gives the 1997 review of food–cancer research by the
World Cancer Research Fund. An updated report is due out in
2006.
The annual WHO World Health Report has shown that cancers
are increasing worldwide,93 and the 2003 World Cancer Report
suggested that, like obesity, rising cancer rates are preventable.
By virtue of steadily ageing populations, cancer could further
increase by 50 per cent to 15 million new cases a year by 2020. In
2000, 6.2 million people died of cancer worldwide (12.5 per cent of
all deaths), but 22.4 million were living with cancer. In the South,
cancers of the oesophagus, liver and cervix are more common,
while in the North, there is a predominance of cancers of the lung,
colon, pancreas and breast.
The most significant cause of death among men is lung cancer
and among women, breast cancer, but certain lifestyle changes,
such as to diet or smoking habits, would alter these patterns.
Some cancers are closely associated with diets centred on well-
 DIET AND HEALTH: DISEASES AND FOOD 81

cooked red meats, animal proteins and saturated fats in large

quantities, with a daily routine that takes in little physical activ-
ity. 94 Indeed, many cancers could be prevented by modifying
dietary habits to include more fruits, vegetables, high-fibre
cereals, fats and oils derived from vegetables, nuts, seeds and
fish, and by limiting the intake of animal fats derived from meat,
milk and dairy products.95, 96 A number of published studies show
that an increase in antioxidant nutrients such as beta-carotene,
vitamins C and E, zinc and selenium could also decrease the risk
of certain cancers and there seems to be strong evidence that
eating a diet rich in fresh fruit and vegetables will reduce the risk
of stomach cancer.97 Yet the nutrition transition is being driven in
a different direction – towards a diet actually higher in processed
foods and animal fats, key food industries within the Productionist
paradigm.

Diabetes

The incidence of Type 2 diabetes is, alarmingly, on the increase.

This form of diabetes was formerly known as non-insulin-
dependent diabetes mellitus (NIDDM), occurring when the body
is unable to respond to the insulin produced by the pancreas; it
accounts for around 90 per cent of cases worldwide. In Type 1
diabetes (formerly known as insulin-dependent), the pancreas
fails to produce the insulin which is essential for survival; this
form develops most frequently in children and adolescents, but
is now being increasingly noted later in life.98 It is anticipated that
cases of Type 2 diabetes will rise coming years (see Table 2.12):
the WHO anticipates a doubling in the number of cases from 150
million in 1997 to 300 million in 2025, with the greatest number
of new cases being in China and India.99
Diabetes is the fourth main cause of death in most developed
countries. Research demonstrates the association between exces-
sive weight gain, central adiposity (fat around the waist) and the
development of Type 2 diabetes. Diabetics are two to four times
more likely to develop cardiovascular diseases than others, and
a stroke is twice as common in people with diabetes and high
blood pressure as it is for those with high blood pressure alone.
In 2000, India recorded 32.7 million diabetics, China 22.6
million and the US 15.3 million, while Brazil recorded only 3.3
Table 2.11 Cancers preventable by dietary means

Global Global Dietary Factors Non-dietary Preventable by Diet

Ranking Incidence (convincing or Risk Factors
(incidence) (1000s) probable) (established)
Low High Low High
estimate estimate estimate estimate
(%) (%) (1000S) (1000S)
mouth and ↓ vegetables & fruitsa ? smokinga
pharynx 5 575 ↑ alcohola ↑ betela 33 50 190 288
nasopharynx ↑ salted fishb ↑ EBVb
larynx 14 190 ↓ vegetables & fruits ↑ smoking 33 50 63 95
↑ alcohol
oesophagus 8 480 ↓ vegetables & fruits ↑ smoking 50 75 240 360
↑ deficient diets ↑ Barrett’s
↑ alcohol oesophagus
lung 1 1320 ↓ vegetables & fruits ↑ smoking 20 33 254 436
↑ occupation
stomach 2 1015 ↓ vegetables & fruits ↑ H. pylori 66 75 670 761
↓ refrigeration
↑ salt
↑ salted foods
pancreas 13 200 ↓ vegetables & fruits ↑ smoking 33 50 66 100
↑ meat, animal fat
gallbladder – c – – – – – –
liver 6 540 ↑ alcohol ↑ MBV and HCV 33 66 178 356
↑ contaminated food
colon, rectum 4 875 ↓ vegetables ↑ smoking 66 75 578 656
↓ physical activity ↑ genes
↑ meat ↑ ulcerative colitis
↑ alcohol ↑ S. sinensis
↓ NSAIDs
breast 3 910 ↓ vegetables ↓ reproductive 33 50 300 455
 ↑ rapid early growth ↑ genes
↑ early menarche ↑ radiation
↑ obesity
↑ alcohol
ovary 15 190 – ↑ genes
↓ reproductive 10 20 19 38
endometrium 16 170 ↑ obesity ↑ OCs
↑ oestrogens
↓ reproductive 25 50 43 85
cervix 7 525 ↓ vegetables & fruits ↑ HPV 10 20 53 105
↑ smoking
prostate 9 400 ↑ meat or meat fat or 10 20 40 80
dairy fat
thyroid – 100d ↑ iodine deficiency ↑ radiation 10 20 10 20
kidney 17 165 ↑ obesity ↑ smoking 25 33 41 54
↑ phenacetin
bladder 11 310 ↑ smoking 10 20 31 62
↑ occupation
↑ S. haematobium
other 2,355 – – 10 10 236 236
Total (1996) 10,320 3022 4187
29.3% 40.6%
Notes: Included as ‘dietary factors’ in this table are various foods, nutrients, alcoholic drinks, body weight and physical activity. The panel has estimated the
extent to which specific cancers or cancer in general are preventable by the dietary and associated factors described in this report. The figures suggested
are ranges consistent with current scientific knowledge as reviewed and assessed in Chapters 4–7, and take established non-dietary risk factors, notably
the use of tobacco, specific infections and occupational exposures to carcinogens, into account.The arrows represent either decreasing risk (↓) or increasing
risk (↑).
Figures on global ranking and incidence: Parkin et al (1993); WHO (1997)
a
: mouth and pharynx; also chewing tobacco
b
: nasopharynx
c
: reliable worldwide data are not collected by IARC for this site
d
: conservative estimate based on the IARC (1993)
Source: Table 9.1.2 in World Cancer Research Fund (1997), Food, Nutrition and the Prevention of Cancer: A Global Perspective. Washington, DC: World
Cancer Research Fund/American Institute for Cancer Research. Reproduced by permission.
84 FOOD WARS

Table 2.12 Prevalence of diabetes worldwide

2000 2030 Projected growth

(%)

Africa 7,020,553 18,244,638 160

Mediterranean 15,189,760 43,483,842 186
Americas 33,014,823 66,828,417 102
European 33,380,754 48,411,977 45
SE Asia 45,810,544 122,023,693 166
Western Pacific 36,138,079 71,685,158 98
Total 171,000,000 366,000,000 114
Source: WHO (2004) Diabetes Action Programme, Geneva, WHO; http://www.who.
int/diabetes/facts/world_figures/en/, accessed 2 June 2004

million and Italy 3.1 million. In 2000, the five countries with the
highest diabetes prevalence in the adult population only were
Papua New Guinea (15.5 per cent), Mauritius (15 per cent),
Bahrain (14.8 per cent), Mexico (14.2 per cent) and Trinidad &
Tobago (14.1 per cent).100, 101 Such disparate statistics reflect a
transition from traditional diet and from an activity-based lifes-
tyle to a more sedentary one. By 2025, the prevalence of diabetes
is anticipated to triple in Africa, the Eastern Mediterranean, the
Middle East and South Asia. It is expected to double in the
Americas and the Western Pacific and to almost double in Europe.
In India, incidence is much higher in urban than rural popula-
tions:102 in urban Chennai (Madras), for example, cases of diabetes
rose by 40 per cent in 1988–1994. Incidence is rising among male
urban dwellers of South India compared to the rural male popula-
tion. In addition to Diabetes mellitus, the prevalence of non-insulin-
dependent diabetes (NIDDM) increased dramatically within the
urban populations of India within just a decade.103 In Thailand,
also, NIDDM is more pronounced amongst females in the urban
population than it is in the rural population,104 whilst in the rural
environment, incidence of NIDDM amongst males is higher.
In the UK, Professor David Barker and colleagues have shown
that adult diabetes is associated with low birthweight,105 while
studies in India suggest that poor interuterine growth, combined
with obesity later in life is associated with insulin resistance,
 DIET AND HEALTH: DISEASES AND FOOD 85

diabetes and increased cardiovascular risk.106 Once again, a single

disease seems attributable to a pattern of poor nutrition related
to the lifecycle, and is one whose costs are externalized onto
society as a whole and health care in particular. Devastating
complications of diabetes, such as blindness, kidney failure and
heart disease, are imposing a huge financial burden: in some
countries 5–10 per cent of national health budgets.

FOOD SAFETY AND FOOD-BORNE DISEASES

Whilst attention to such non-communicable diseases is of vital
importance, food safety, food-borne diseases and other com-
municable diseases remain uppermost within food and public
health policy, partly due to consumer campaigns about risks and
to heightened media awareness of poor food processing stand-
ards. Food safety problems include risks from:107

l veterinary drug and pesticide residues;

l food additives;
l pathogens (ie illness-causing bacteria, viruses, parasites,
fungi and their toxins);
l environmental toxins such as heavy metals (eg lead and
mercury);
l persistent organic pollutants such as dioxins;
l unconventional agents such as prions associated with BSE.

In particular, companies have had to respond to new public

awareness about food safety issues, and new regimes of trace-
ability have been implemented to enable companies to track food
ingredients in order to eliminate subsequent legal or insurance
liability consequences. In this respect, food companies are anx-
ious to present themselves as guardians of the public health.108 The
attention food safety receives is predictably higher in affluent
countries when, on the evidence, the burden of ill health is far
greater in the developing world, due to lack of investment and
infrastructure, including drains, housing, water supplies and
food control systems. The World Health Report 2002 pointed out
that, in developing countries, water supply and general sanita-
tion remain the fourth highest health-risk factor, after under-
weight, unsafe sex and blood pressure.109 In developing countries
86 FOOD WARS

which are building their food export markets, there is too often a
bipolar structure, with higher standards for foods for export to
affluent countries than for domestic markets. There ought to be a
cascading down into internal markets of these higher standards.110
Environmental risks to health are a significant problem on the
global scale and, in Western countries in the 1990s, new strains
of deadly bacteria such as E. coli 0157 captured policy attention,
an estimated 30 per cent of people having suffered a bout of food-
borne disease annually. The US, for instance, reports an annual
76 million cases, resulting in 325,000 hospitalizations and 5000
deaths.111 The WHO estimates that 2.1 million children die every
year from the diarrhoeal diseases caused by contaminated water
and food,112, 113 asserting that each year worldwide there are
‘thousands of millions’ of cases of food-borne disease.114
In early industrializing countries, a grand era of engineering
made dramatic health improvements in public health (a story we
return to in Chapter 3). Part of that investment included the
introduction of effective monitoring and hygiene practice syst-
ems, such as the establishment of local authority laboratories and
training, the packaging of foods and processes such as milk
pasteurization. Today, public health proponents are actively
trying to promote a ‘second wave’ of food safety intervention but
this time using a risk-reduction management system known as
Hazards Analysis Critical Control Point (HACCP), an approach
designed to build safety awareness and control of potential
points of hygiene breakdown into food handling and manage-
ment systems. HACCP also encourages the creation of a ‘paper’
trail to enable tracking along the production process, essential in
order to obviate errors and enable learning. Breakdowns in food
safety have in the past led to major political and business crises,
with governments under attack and new bodies responsible for
food safety being set up in many countries. As food supply chains
become more complex and as the scale of production, distribu-
tion and mass catering increases, so the chances for problems
associated with food contamination rise; mass production break-
downs in food safety spread contamination and pathogens widely.
An outbreak of Salmonellosis in the US in 1994, for example,
affected an estimated 224,000 people.115 Listeria monocytogenes has
a fatality rate of 30 per cent, a fact that seriously dented UK public
confidence in the ‘cook–chill’ and ‘oven-ready’ foods of the late
1980s.
 DIET AND HEALTH: DISEASES AND FOOD 87

Cross-border trade in agricultural and food products, as well

as international pacts have brought food safety to the fore.116 The
Director-General of the WHO, in a speech on food safety to the
UN Codex Alimentarius Commission, said: ‘globalisation of the
world’s food supply also means globalisation of public health
concerns.’117 Crises over BSE, Salmonellosis and E. coli, for example,
had had a significant political impact throughout both the UK
and EU, for instance,118 and many countries have experienced a
fast rise in incidences of Salmonellosis and Campylobacter infec-
tions since the 1980s, both bacteria being associated with meat
and meat products. Despite countries such as Denmark and
Sweden having strict policies governing the extermination of
flocks and herds found to be carrying Salmonella, the incidence
continues through the contamination of feedstuffs, and in Den-
mark in 1998 the percentage of positive flocks with Campylobacter
was 47.1 per cent.
Thus, in many developed countries with good monitoring
systems, the incidence of food-borne disease has in fact risen
during the era of the Productionist paradigm: in West Germany
cases of infectious S. enteritis rose from 11 per 100,000 head of
population in 1963 to 193 per 100,000 in 1990;119 in England and
Wales formal notifications of the same disease rose from 14,253
cases in 1982 to 86,528 in 2000. These cases resulted in millions of
days lost from work but, fortunately, relatively few deaths.
Bacteria fill gaps left by nature, evolving new strains; but they
are constantly evolving even as science combats existing strains.
The new food processes and systems of distribution ushered in
by the food technology revolution of the second half of the 20th
century provided many opportunities for bacteria to develop
and colonize new niches. The incidence of Salmonella in the UK,
for example, first rose, and then, following good monitoring,
hygiene intervention and political pressure, fell right back – in
two decades.
Table 2.13 gives a list from the WHO of some of the patho-
genic organisms that are associated with food and food hygiene:
viruses, bacteria, trematodes (flukeworms), cestodes (tapeworms)
and nematodes (roundworms), the last three all small worms that
can be found either in soil, fish or meats. The first two are con-
cerns in global food trade particularly. In the case of bacteria such
as Listeria monocytogenes, only 657 cases were reported through-
out the European Union in 1998;120 in the same period, deaths
88 FOOD WARS

Table 2.13 Some pathogenic organisms associated with public health,

which may be transmitted through food

Bacteria Protozoa
Bacillus cereus Cryptosporidium spp
Brucella spp Entamoeba histolytica
Campylobacter jejuni and coli Giardia lamblia
Clostridium botulinum Toxoplasma gondii
Clostridium perfringens
Escherichia coli
(pathogenic strains) Trematodes (flukeworms)
Listeria monocytogenes Fasciola hepatica
Mycobacterium bovis Opistorchis felineus
Salmonella typhi and paratyphi
Salmonella (non-typhi) spp Cestodes (tapeworms)
Shigella spp Diphyllobotrium latum
Staphylococcus aureus Echinococcus spp
Vibrio cholerae Taenia solium and saginata
Vibrio parahaemolyticus
Vibrio fulnificus Nematodes (roundworms)
Yersinia enterocolitica Anisakis spp
Ascaris lumbricoides
Viruses Trichinella spiralis
Hepatitis A Trichuris trichiura
Norwalk agents
Poliovirus
Rotavirus
Source: WHO European Centre for Health and Environment, Rome, 2000

from cardiovascular disease in the EU totalled 1.5 million, 42 per

cent of all deaths,121 while, in 1990, diarrhoeal diseases accounted
for 11,000 years of life (DALYs) lost out of a total of 22.7 million
in Europe; in the same year, cardiovascular disease accounted for
7 million diabetes for 371,000 and cancer of the colon and rectum
for 593,000,122 and five times as many years of life were lost due
to drug addiction than to diarrhoeal diseases.
Despite a low health burden in the developed world, the
financial costs of food poisoning can be significant. Estimates in
the US suggest that the diseases caused by major pathogens cost
up to $35 billion each year in medical costs and lost product-
ivity.123 Policy-makers must be concerned about both food-borne
illness and degenerative diseases, the latter of which do not as yet
receive sufficient political attention.
 DIET AND HEALTH: DISEASES AND FOOD 89

INEQUALITIES AND FOOD POVERTY

After all the corporate hyperbole in the 1990s about globalization
unleashing wealth for all, a series of UN and other reports
reminded the world that, whatever the wealth accrual, its
distribution would remain unequal. As one commentator on
globalization put it: ‘. . . half a century of accelerated globali-
sation has clearly not eliminated poverty from the face of the
earth. On the contrary, although the abject poor have decreased
since 1960 as a proportion of the world’s population, their abso-
lute number has grown.’ 124 A new global class structure has
emerged from the crisis in health. Diet-related ill health is great-
est among poorer socio-economic groups who are locked into a
cycle of either hunger and premature death, or of malnutrition,
and obesity and degenerative diseases. An equitable food supply
would help break this cycle. Even in India where there are ex-
tremes of pressure – social, economic, environmental and climatic
– lack of adequate diet for a whole-population health is socially
determined125 by caste, politics and economic policy.
In absolute terms, more people live in poverty today than 20
years ago. About a fifth of the world’s population, 1.3 billion
people, live on a daily income of less than US$1; by 2015 the
number of people subsisting below this international poverty
line is on line to reach 1.9 billion.126 Although most of the world’s
poor live in South and East Asia, sub-Saharan Africa has the
fastest growing proportion of people who live in poverty.127 But
poverty is not confined to developing countries and women,
children, and older people are at greatest risk. The health of the
poor is, concomitantly, at risk from environmental hazards such
as unsafe food and water, and from urban hazards such as air,
and water pollution and accidents. In 1900 around 5 per cent of
the world’s people lived in cities with populations exceeding
100,000. Today, an estimated 45 per cent – more than 2.5 billion
people worldwide – live in large urban centres, and this is ex-
pected to rise to 61 per cent by the year 2025.128
According to the tenth annual UN Development Programme
Human Development Report of 1999, the richest 20 per cent of
the world’s population now account for 86 per cent of world
gross domestic product (GDP), while the poorest 20 per cent have
just 1 per cent.129 Two hundred of the world’s richest people
doubled their net worth in the last four years of the 20th century.
90 FOOD WARS

The richest three people in the world have assets greater than the
combined gross national product of all the least developed
countries in the world, accounting for 600 million people. The net
worth of the 358 richest people equals the combined income of
the poorest 45 per cent of the world’s population – about 2.3
billion people.130
Income differentials are also increasing. In 1960, 20 per cent
of the world’s population living in the richest countries earned
30 times the income of the poorest 20 per cent; by 1997, the richest
20 per cent earned 74 times the income of the poorest 20 per
cent. The UNDP 1999 report called for tougher rules on global
governance, including principles of performance for multi-
nationals on labour standards,131 fair trade and environmental
protection; by 2003, the tone being taken by UNDP was harsher:
it reported the 1990s as a period when inequalities widened
rapidly, with 50 countries suffering falling living standards in the
1990s. The richest 1 per cent of the world’s population, around
60 million, now receives as much income as the poorest 57 per cent,
while the income of the richest 25 million Americans is equivalent
to that of almost 2 billion of the world’s poorest people.132
Attempting to face this crisis, its findings helped to create
what are known as the UN’s Millennium Development goals all
to be met by 2015.133 Food features in six out of the eight goals:

l to eradicate extreme poverty and hunger;

l to achieve universal primary education;
l to promote gender equality and empower women;
l to reduce child mortality;
l to improve maternal health;
l to combat HIV/AIDS, malaria and other diseases;
l to ensure environmental sustainability;
l to develop a global partnership for development.

Some critics argue, worthy though such goals are, they are un-
likely to yield any narrowing of inequalities if unaccompanied by
firm policies to redistribute wealth from the rich to the poor, an
economic anathema in dominant policy circles.134 The widening
disparity between social classes means that the rich, even in poor
societies, have access to healthier dietary choices; they are also
most likely to be tempted by imported, processed items contain-
ing higher levels of fat, sugar and salt. The poor living in rural
 DIET AND HEALTH: DISEASES AND FOOD 91

areas may have a more restricted diet based on a staple food

usually grown on their own land, but the urban poor eat only
what they can afford to buy, often suffering vitamin and mineral
deficiencies as a result.
In the late 1990s, UNICEF was providing evidence of over 6
million annual deaths of children under five attributable to
malnutrition.135 More than 25 per cent of all children under five
years old are underweight.136 In South America and sub-Saharan
Africa, the child malnutrition rates have increased. The risk of
mortality rises swiftly if a child is even mildly malnourished:
dehydration from diarrhoea kills 2.2 million children every year;
children who are malnourished develop lifetime disabilities and
weakened immune systems and are therefore more susceptible
to infectious diseases, as highlighted in the lifecycle model
presented (Figure 2.8 on page 62). In addition, under-nourished
children suffer impairment of their cognitive skills through lack
of nutrients and calories.
UNICEF calculates that South Asia has the highest numbers
of stunted children, followed next by sub-Saharan Africa, whereas
Latin America has the lowest prevalence of under-fives suffering
from underweight, wasting and stunting. In South Asian coun-
tries such as Sri Lanka over 25 per cent of children under five
years suffer from moderate or severe stunting and over 33 per
cent suffer from moderate and severe underweight. In addition,
UNICEF claims that iodine deficiency is the biggest cause of
preventable brain damage in foetuses, estimating that, in the late
1990s, there were 11 million adults worldwide suffering from
cretinism and 760 million with goitres. A global campaign to
iodize all salt would reduce this number; indeed, by 2002, the
percentage of countries selling only iodized salt had increased
from 20 per cent to 72 per cent. But there were still 32 countries
where less than half the households consumed iodized salt, and
health advice is now to restrict salt intake, as it is a risk factor for
hypertension.137 Generally, though, iodization is a rare policy suc-
cess; perhaps because it did not threaten food industry interests.
92 FOOD WARS

THE CHANGING MEANINGS OF

FOOD SECURITY
In public policy, the term ‘food security’ is often invoked in
respect of a new food system to reduce worldwide figures on the
under-nourished.138 The 1996 World Food Summit defined food
security as the situation in which at the individual, household,
national, regional and global levels ‘all peoples, at all times, have
physical and economic access to sufficient, safe and nutritious
food to meet their dietary needs and food preferences for an
active and healthy life’.139 In the 1940s, when the WHO and the
FAO were set up under the new United Nations, the policy
priority was to increase food supply in every continent and
nation; this macro-focus was still the dominant paradigm at the
time of the 1974 World Food Conference, after which research on
food security has mushroomed, and by the 1980s attention had
shifted more towards household and individual access to food
and towards improving what might be called ‘micro-food’ secur-
ity. Four core foci emerged:

l sufficiency of food for an active healthy life;

l access to food and entitlement to produce, purchase or ex-
change food;
l security in the sense of the balance between vulnerability, risk
and insurance;
l time and the variability in experiencing chronic, transitory
and cyclical food insecurity.

Summing up thinking in this micro-focus period, one research

team remarked that ‘flexibility, adaptability, diversification and
resilience are key words. Perceptions matter. Intra-household
issues are central . . . Food security must be seen as a multi-
objective phenomenon, where the identification and weighting
of objectives can only be decided by the food insecure them-
selves.’140 Maxwell, who coordinated the research after working
on food security in the Sudan in the late 1980s, argued:

A country and people are food secure when their food system operates
in such a way as to remove the fear that there will not be enough to
eat. In particular, food security will be achieved when the poor and
 DIET AND HEALTH: DISEASES AND FOOD 93

vulnerable, particularly women and children and those living in

marginal areas, have secure access to the food they want. Food security
will be achieved when equitable growth ensures that these people have
sustainable livelihoods. In the meantime and in addition, however, food
security requires the efficient and equitable operation of the food
system.141

NGOs tend to take a more value-led approach. The Canadian

World Food Day Association, for example, sees food security
with the following principles:

l that the ways and means in which food is produced and

distributed are respectful of the natural processes of the earth
and are thus sustainable;
l that both the production and consumption of food are
grounded in and governed by social values that are just and
equitable as well as moral and ethical;
l that the ability to acquire food is assured;
l that the food itself is nutritionally adequate and personally
and culturally acceptable;
l that the food is obtained in a manner that upholds human
dignity.142

By the 1990s, whether in the North or South, there was a com-

monality of ideas about what was meant by food security: the
issue of appropriateness of food supply rather than just suffi-
ciency was now accepted to be central.143 An ecological tinge was
infusing what had first been a more conventional notion of
nutritional adequacy. Over time, the notion of food security had
taken on a concreteness and value within global food governance.
This happened mainly because some key professions adopted
and promoted the term. International anxieties, mass-media
coverage of famines and demographic and supply studies had all
focused on the need for enough food to feed the growing world
population. Attempts to reduce international debt, featuring
highly in G8 meetings, built on concerns about large-scale food
production initiatives such as the Green Revolution. Develop-
ment economists had measured food consumption, through
household budget surveys, in terms of calories purchased, as a
key indicator of general poverty. The World Bank used food
security analysis as a way of mapping the poverty of a country.
94 FOOD WARS

Nutritionists and famine relief agencies took measures to aid in

the prediction of world food emergencies and to prevent their
worst effects. Finally, an increasingly active body of development
workers, articulating the view that maldistribution of power was
what lay behind food insecurity, developed strategies to help
empower local communities to address their own food needs. For
all of those people, food security remains a goal, not just a tool of
analysis.
This notion of food security has long historical roots. The first
director of the FAO, John Boyd Orr, mapped out what he thought
the post-War vision to ensure food security should be. This was
a vision largely framed by the experience of rich countries in the
‘Hungry Thirties’.144 The vision focus was on availability and
increase of the food supply:

1 Countries should set targets within a new global system and

foster intergovernmental cooperation to help each other
over good times and bad, to ease out booms and slumps in
production.
2 Targets should be based on science, above all on nutrition and
agricultural science.
3 Targets should be set to achieve health. Premature death from
under-nutrition is inexcusable; investment in better food will
yield health and economic gains and savings.
4 Agriculture should be financially and politically supported
to produce more.
5 Industry should be geared to produce tools to enable agricult-
ural productivity to rise: new buildings, tractors, equipment.
6 Trade should be encouraged to meet the new markets and to
ease the over-productive capacity of some areas and match
them with under-consumption in other areas.
7 International cooperation will have to follow the (proposed)
UN Conference on Food and Agriculture.
8 New organizations will have to be created such as a new
International Food and Agricultural Commission, National
Food Boards to monitor supplies, Agricultural Marketing
Boards, Commodity Boards.145
 DIET AND HEALTH: DISEASES AND FOOD 95

FOOD POVERTY IN THE WESTERN WORLD

Most public health concern about food poverty rightly centres on
the developing world, but it is also important to recognize that
the impact of food poverty is significant in the developed world.
The new era of globalization has unleashed a reconfiguration of
social divisions both between and within countries; these social
divisions are particularly marked in societies such as the UK and
the US which have pursued neo-liberal economic policies. Indeed,
one review of EU food and health policies estimated that food
poverty was far higher in the UK than any other EU coun-
try,146 where inequalities in income and health widened under the
Conservative government of 1979–1997. The proportion of
people earning less than half the average income grew147 and the
bottom tenth of society experienced a real, not just relative,
decline in income and an increase in social health distinctions.
This was a the converse of the post-World War II years of
Keynesian social democratic policies during which inequalities
narrowed: lower UK socio-economic groups now experience a
greater incidence of premature and low birthweight babies, and
of heart disease, stroke and some cancers in adults. Risk factors
such as bottle-feeding, smoking, physical inactivity, obesity,
hypertension, and poor diet were clustered in the lower socio-
economic groups148 whose diet traditionally derives from cheap
energy forms such as meat products, full-cream milk, fats, sugars,
preserves, potatoes and cereals with little reliance on vegetables,
fruit, and wholemeal bread. Essential nutrients such as calcium,
iron, magnesium, folate and vitamin C are more likely to be
ingested by the higher socio-economic groups:149, 150 their greater
purchasing power creates a market for healthier foods such as
skimmed milk, wholemeal bread, fruit and other low-fat options.
Similarly, in the US, hunger has been a persistent cause of
concern for decades and rising during the 1990s when the Census
Bureau calculated that 11 million Americans lived in households
which were ‘food insecure’ with a further 23 million living in
households which were ‘food insecure without hunger’ (in other
words at risk of hunger).151 Other US surveys of the time estim-
ated that at least 4 million children aged under 12 were hungry
and an additional 9.6 million were at risk of hunger during at
least one month of the year. Despite political criticisms of these
96 FOOD WARS

surveys, further research suggested that even self-reported

hunger, at least by adults, is a valid indication of low intakes of
required nutrients. It should be noted that, ironically, the US,
spent over $25 billion on federal and state programmes to pro-
vide extra food for its 25 million citizens in need of nutritional
support.152

IMPLICATIONS FOR POLICY

This chapter has sketched the bare bones of a highly complex
global picture of diet-related health. Over the last half-century,
epidemiologists have generated many facts, figures and argu-
ments about the role of food in the creation and prevention of ill
health, linking what humans eat with their patterns of disease.
They raise a number of important questions: how much of a risk
does poor diet pose? What proportion of the known incidence of
key diseases like cancer, heart disease, diabetes and microbio-
logical poisoning can be attributed to the food supply? What
levels of certainty can be applied to the many studies that have
been produced? Is diet a bigger factor than, say, tobacco or
genetics? For policy-makers, the uncomfortable fact is that the
pattern of diet-related diseases summarized in this chapter
appears to be closely associated with the Productionist para-
digm. Whilst the paradigm had as its objective the need to
produce enough to feed people, its harvest of ill health was
mainly sown in the name of economic development. Yet the
public health message is clear: if diet is inappropriate or inade-
quate, population ill health will follow. Diet is one of the most
alterable factors in human health, but despite strong evidence for
intervention, public policy has only implemented lesser meas-
ures such as labelling and health education while the supply chain
remains legitimized to produce the ingredients of heart disease,
cancer, obesity and their diet-related degenerative diseases.
In making these tough assertions, we are aware that to piece
together all food research evidence is immensely complex: more
research is always needed; scientific understanding inevitably
advances and is refined along the way. But surely, there is enough
evidence for action. Certainly there is no shortage of reports and
studies with which to inform policy. Calling for more research
 DIET AND HEALTH: DISEASES AND FOOD 97

ought not to be an excuse for policy inaction. Policy procrastina-

tion is merely poor political prioritization.
Policy attention needs to shift from the overwhelming focus,
enshrined in the Productionist paradigm, on under-consumption
and under-supply to a new focus on the relationship between the
over-supply of certain foodstuffs, excessive marketing and mal-
consumption, and do so simultaneously within and between
countries. Historically, there has been too much focus on public
education as the main driver of health delivery; the diet and health
messages, while welcome, have not always had the widespread
or long-lasting effect that current data suggests is needed. While
there have been reductions, for example, in coronary heart disease
mortality rates in affluent societies, this is not universally true,
and health education as framed in the West may not be univers-
ally appropriate. The food supply chain itself must be re-framed
and must target wider, more health-appropriate goals.
Even rich countries are struggling to provide and fund equit-
able solutions to problems caused by diet: drugs and surgery,
designer health foods, scientific research and public health
education. But for developing countries, the majority of human-
ity, who have even fewer resources and weaker health care
infrastructure, the picture is even more desperate. At the heart of
the food policy challenge is the need to reinforce the notion of
entitlement to food. While the 1948 Universal Declaration of
Human Rights asserted the right to food for health for all, even
into the new millennium the call is still not being adequately met,
and, for humanity’s sake, it must now be pursued with more
vigour.
98 FOOD WARS

CHAPTER 3
POLICY RESPONSES TO
DIET AND DISEASE
‘War is probably the single most powerful instrument of dietary change
in human experience. In time of war, both civilians and soldiers are
regimented – in modern times, more even than before. There can occur at
the same time terrible disorganization and (some would say) terrible
organization. Food resources are mobilized, along with other sorts of
resources. Large numbers of persons are assembled to do things together
– ultimately, to kill together. While learning how, they must eat together.
Armies travel on their stomachs; generals – and now economists and
nutritionists – decide what to put in them. They must do so while
depending upon the national economy and those who run it to supply
them with what they prescribe or, rather, they prescribe what they are
told they can rely upon having.’

Sidney Mintz, anthropologist of food, USA, b 19221

CORE ARGUMENTS
There has long been a struggle to inject nutrition into state
food policy. In the 20th century, understanding of food’s
role in meeting public health objectives fluctuated con-
siderably with the mixes of scientific advance and social
upheaval, notably war and domestic change. Nutrition
has now split into two strands: one focused on social
objectives such as poverty reduction, the other on bio-
chemical mechanisms. For the Productionist paradigm,
dietary guidelines have been the main battleground in
nutrition and food policy. There is now a renewed interest
in creating an integrated approach to food, diet and health.
This could sit comfortably with the Ecologically Integrated
paradigm and, in part, with the Life Sciences Integrated
 POLICY RESPONSES TO DIET AND DISEASE 99

paradigm, too. A recurring concern in the discourse about

nutrition and health is whether public and corporate
policy should be focused on individuals or on populations.

INTRODUCTION
The scientific evidence for diet-related disease has not gone
unnoticed within governments. In fact, governments’ health
ministries have helped create the evidence through statistical
surveys and funding academic studies, but ensuing policy
actions have in many instances been blunted or recommenda-
tions left to gather dust on forgotten shelves. The state apparatus
of the Productionist paradigm has been controlled by the
ministries most associated with production: usually agriculture
and not health. Until recently, any connection between health
ministries and the mass of evidence in relation to diet, disease
and food supply has been subverted or resisted. This is despite
more than 100 authoritative scientific reports between 1961 and
1991 recommending dietary change in relation to disease and
health being published throughout the world.2
Despite this mounting body of evidence, health-focused state
intervention in food supply, has been rare. Yet, in theory, there has
been international public and nutrition policy commitment to
address disease and health. But this has not happened by chance.
In this chapter we describe what has been a 100-year food battle
to bring nutrition policy to the forefront in state thinking on diet
and health. We look at supply chain policy later.
The key sticking point in public health and nutrition policy is
this: is it the ‘individual’ or the ‘population-based’ approach to
food policy which is better? It is our view that health is not simply
a personal choice, but that it reflects processes at work
in wider society that require a full public response in order to
set the framework within which individuals can make health-
enhancing choices. However, to date much policy action has been
directed solely at individuals, usually exhorting them to greater
self-control and dietary restraint and balance. But what should a
public policy response for the future be? We see this discussion
as crucial since it will demonstrate the deep roots of the tensions
100 FOOD WARS

between the Life Sciences Integrated paradigm and the Eco-

logically Integrated paradigm and the urgent need for an
integrated ecological approach to nutrition and health policy.

CHANGING CONCEPTIONS OF HEALTH

Current public health has its roots in 19th-century Western
reactions to industrialization. The downside of the newly rich
and mechanized nation states was disease and poverty on an
unprecedented scale,3 and a new generation of social reformers
began to argue that ill health both penalized its victims and
threatened the fabric of society. In Victorian Britain a new
approach to public health gradually emerged from this realiza-
tion, pushed into legislation not by medical men but by civil
servants such as Edwin Chadwick who framed the Public Health
Act of 1848,4, 5 and its implementation had to be fought for every
step of the way.
One can get an idea of the nature of that battle by comparing
today’s unplanned urban sprawl in poorer countries with the
paved orderliness of British cities where this reform took place
over a century ago. Despite the railway age enabling the middle
classes to live away from the squalor of the urban sources of their
wealth, it was clear that ill health could not be escaped: diseases
and pollution still prevailed. Containment, investment and
prevention policies were reluctantly adopted. Unmade roads and
open sewers were replaced by pavements, tarmac and drains.
Slowly, over decades, better standards of housing and water and
food provision were achieved, but not without contradictions.
Pollution (industrial and human), for example, was flushed away
from areas of habitation and work into the sea and the land in a
manner that today would be unacceptable.
This huge investment in public health engineering – drains,
roads, better housing – was based in part on the realization by
the state that this same investment would deliver widespread
health gains. This engineering solution is the classical notion
of public health, but if offered material solutions in a ‘moral’
package for both the affluent and the poor. Today, this classical
notion of public health as social engineering has been margin-
alized; in its place is an individualized conception in which
we become ‘consumers’ of health and choose our own options
 POLICY RESPONSES TO DIET AND DISEASE 101

for health – or not.6 This was rooted in and legitimized by the

triumph of neo-liberal economics in the 1970s and 1980s in
Western democracies. Their ostensibly new notion of health was
new in appearance only, since its roots lay in 19th-century liberal
economics: in the academic world and, more importantly, in key
global financial institutions such as the World Bank and the
International Monetary Fund. A new orthodoxy proposed that
state involvement in health should be reduced, that pricing and
market mechanisms could manage services more efficiently and
that privately run insurance was preferable to public schemes.7
Margaret Thatcher, the UK Prime Minister at the time,
famously asserted that there was no such thing as society; social
goods (such as investment in public health) were no more than
multiple individual transactions which would be better left to the
private sector and private transactions between the consumer
and the service provider. The core notion was consumer choice
rather than citizens’ rights.8 The challenge which she and others
posed to defenders of the classical notion of public health was to
fight out whether public health remained relevant and whether
or not health investment was a societal responsibility. Despite
this ideological marginalization in which food has been a key
battleground, the case for a new public health has become ever
more powerful.

CHANGING CONCEPTIONS OF PUBLIC HEALTH

A former Chief Medical Officer of England defined the practice
of public health as ‘the science and art of preventing disease,
prolonging life and promoting health through the organised
efforts of society’.9 At the core of many definitions of public health
is the notion that health is not an individual but a social phenom-
enon and that the social and natural environment frames the
chances of people getting or preventing disease. We make a
distinction between public health and a ‘new’ public health for
the purposes of emphasizing significantly different approaches
to health, and the methods of solving public health problems.10, 11
Despite, in fact, having been used as early as 1911, the term
‘new public health’ is associated with a modern analysis of the
ways in which lifestyles and living conditions determine health
status. It also recognizes the need to mobilize resources and make
102 FOOD WARS

sound investments in policies, programmes and services which

create, maintain and protect health by supporting healthy
lifestyles and creating supportive environments for health.
A concept of ‘ecological public health’ has also emerged in
response to the changing nature of health issues and their
interface with emerging global environmental problems,12, 13 such
as the destruction of the ozone layer, air and water pollution and
global warming, all of which have a substantial impact on health
and often elude simple models of causality and intervention.14, 15
It emphasizes the common ground between achieving health and
sustainable development, and it focuses on the economic and
environmental determinants of health and on guiding invest-
ment towards optimal public health and sustainable use of
resources.16
In 1998 the WHO proposed a ‘new public health’ focused
upon ‘lifestyles and living conditions [which] determine health
status’, and whose challenge is to ‘mobilise resources and make
sound investments in policies, programmes and services which
create, maintain and protect health by supporting healthy life-
styles and creating supportive environments for health’.17 A more
recent definition called for:

an approach which brings together environmental change and person

preventative measures with appropriate therapeutic interventions,
especially for the elderly and disabled. [H]owever, the New Public
Health goes beyond an understanding of human biology and recognises
the importance of those social aspects of health problems which are
caused by lifestyles.

In this way it seeks to avoid the trap of blaming the victim. Many
contemporary health problems are therefore seen as being social rather
than solely individual problems; underlying them are concrete issues
of local and national public policy, and what are needed to address
these problems are ‘Healthy Public Policies’ – policies in many fields
which support the promotion of health. In the New Public Health, the
environment is social and psychological as well as physical.18

This interpretation, though forward thinking at the time, still

emphasizes ‘those social aspects of health problems which are
caused by lifestyles’ whereas our conception of ecological public
health emphasizes that unhealthy lifestyles are influenced by
social and environmental factors. Such a perception of health is
 POLICY RESPONSES TO DIET AND DISEASE 103

Poverty Economic
reduction growth

Increased Improved Social sector investments

productivity nutrition, nutrition
growth and health
development education

Enhanced
human
capital

Source: R Martorell (1996) ‘The role of nutrition in economic development’, Nutrition

Reviews, 54, 4, S66–S71

Figure 3.1 Nutrition, health and economic growth

illustrated by a model developed by Martorell who integrates

economic and social factors into nutrition and health (see Figure
3.1), and places importance on social investment not just in health
and education but also in nutrition.
This discussion of public health is a reminder that public
health can mean different things. There is now a consensus that
a public health perspective has to focus on the causes of ill health
and on the factors which promote good health, rather than on the
symptoms of ill health. The ethos of the new ecological public
health is prevention rather than cure on an environmental, not
just societal, basis. This has considerable implications for the food
supply chain.

THE NUTRITION PIONEERS: A 100-YEARS WAR

Nutrition policy is a distinct part of public health policy which,
like public health, has fought hard to gain a place at the political
104 FOOD WARS

table. Dr James Lind,20 although not the first to note the connection
between diet and ill health, is often credited with putting modern
nutrition onto a scientific basis. With trade routes dependent
upon the health of ships’ crews, the problem of scurvy was a
major threat: it could devastate entire ships’ crews. In 1753 Lind
published the results of the first controlled study and established
conclusively that scurvy could be prevented and cured by intro-
ducing citrus fruit into the diet. This was an early indication of
how the science of nutrition could contribute to economic and
even military well-being. Napoleon Bonaparte is famously stated
to have said that an army marches on its stomach and to have
initiated in the late 18th century the search that delivered can-
ning, the means to perfect, portable and long-lasting food. (He
also began the French sugar beet industry!).
Two and a half centuries on, nutrition covers a vast field
ranging from social nutrition (for example, studying ‘at risk’
social groups), nutritional epidemiology (plotting the contribu-
tion of diet to diseases), biochemistry (the study of the bio-
chemical interaction of nutrients and the body), sports and
animal nutritions (optimizing physiological performance) and
psychophysiology (including the study of food choice).
Partly fuelled by huge pharmaceutical and food-industry
research funds, it is biochemistry that dominates nutrition
today, with its researchers seeking profitable health benefits from
within the diet. This pursuit began with Sir Frederick Gowland
Hopkins’ discovery in 1901 that the human body could not make
the amino-acid triptophan, an essential part of protein, and that it
could only be derived from the diet, demonstrating the principle
that, without a proper diet, bodily function could be impaired or
deficient.21 Hopkins proved the existence of what he called food
hormones or ‘vitamines’ (sic), most of which had been discovered
by the end of the 1930s.
Nutrition, like any study concerning humans, is inevitably
framed by social assumptions. Some see the pursuit of better
nutrition as a social duty, while others view nutritional science
as a tool of greater social efficiency or as an end in itself. Through-
out the 20th century, nutrition was a battleground with some
forces using it as an opportunity for social control and others
arguing that it could liberate human potential. This tension
between social control and democracy – ‘top-down’ science
versus people-oriented science – still characterizes the world of
food.
 POLICY RESPONSES TO DIET AND DISEASE 105

W O Atwater, an influential 19th-century American nutri-

tionist, was an early critic of the national diet, but he also pursued
a mechanistic approach to understanding food as fuel in physical
labour: he calculated how much or little nutrient intake was
required by different grades of manual workers, according to
whether they were engaged in moderate or heavy work;22, 23 he
produced estimates of the protein, fat and carbohydrate required
of workers performing light, heavy or moderate work.24 His work
was taken up east of the Atlantic by B Seebohm Rowntree, scion
of a giant UK chocolate dynasty (now owned by Nestlé) and
a founding father of UK food and welfare policy. Throughout
the first half of the 20th century, Rowntree conducted both
domestic and industrial surveys in his home town of York based
on Atwater’s calculations of nutritional need.25, 26, 27 Rowntree
used Atwater ’s minimalist approach to nutrition in order to
accurately assess the needs of the poor: his minimum criteria
made his findings about UK poverty all the more shocking.
In their desire to impose order on food systems, the pioneers
of social nutrition developed and promulgated an approach that
may seem simplistic today but which was enormously influ-
ential. In 1915 TB Wood and Sir Frederick Gowland Hopkins
summarized its value:28

The human body, though doubtless in many of its aspects something

more than a mere machine, resembles the steam-engine in two respects.
It calls for a constant supply of fuel, and as a result of doing work, it
suffers wear and tear. The body must burn fuel in order that the heat
it is always giving off may be continuously replaced; and it must burn
still more fuel whenever it does work. From this necessity there is no
escape . . . It is, of course, the food eaten which provides these funda-
mental needs of the body; and if we are to understand properly the
nutrition of mankind, we must bear in mind the two distinct functions
of food – its function as fuel and its function as repair material.

Arguments about whether diets should be calculated at a min-

imal or adequate level are inevitably politically highly charged.
Not for the first or last time, diets were tinged with morality.
To someone on low income or experiencing food insecurity,
it matters considerably whether an expert or an employer or
the state is promoting better understanding of their diet in
order to shave wages to a minimum or to make improvements
in social conditions and individual well-being. Governments and
106 FOOD WARS

employers might wish for greater influence, but should nutri-

tional scientists collude or differ? During the 1930s’ recession, as
British wages and social welfare collapsed, a British Medical
Association committee courageously argued that state wel-
fare should not be based on an Atwater-type subsistence or
bare minimum diet, but on one conducive to maintaining both
‘health and working capacity’:29 optimum rather than minimum
nutrition. Such historic debates highlighted nutrition’s social
assumptions and also highlight the fact that they hinged on a
view of the food–body interface as an input–output system, with
bodies as machines for which food is fuel and from which labour
is the output. This somewhat mechanistic model began to be
dismantled in the late 20th century with the emergence of bio-
chemistry and the triumph of the doctrine of choice.

A MORE SOPHISTICATED APPROACH TO

FOOD AND NUTRITION
An early exponent of a more complex approach to food and
nutrition was paradoxically someone whose work might have
led him to adopt the ultimate in food-control philosophies. Sir
Robert McCarrison was a Director of the Army Medical Service
in India, and he questioned the view of food as mere fuel, having
been alerted to the impact of poor nutrition by the lamentable
health of British army recruits.30 This had first surfaced as a major
issue following the Boer War when the British government set up
an interdepartmental Committee on Physical Deterioration to
address the eugenic argument that, unless more attention was
paid to ensuring that the ‘fitter’ members of society produced
more children and fed them well, it would be radically weak-
ened. In its 1904 report, the Committee adopted a line of national
self-interest and promoted optimal feeding, especially in the light
of the parlous state of children’s nutrition,31 while McCarrison
argued that, although a degree of self-interest was in order,
nutrition does not act as an on–off switch, with the consumer
having only enough or not enough;32 gradations must be con-
sidered and vitamins introduced to improve the functioning of
the body as a whole and not just to prevent specific diseases.
McCarrison’s view was that optimum nutrition was essential for
 POLICY RESPONSES TO DIET AND DISEASE 107

a sound society, being the lubricant between good agriculture

and good health. Education was the key, he argued: science
should inform citizens and not control them.
Others, such as Sir John (later Lord) Boyd Orr, the first
Director of the FAO, put more emphasis on structural factors.
Boyd Orr founded the Rowett Research Institute at Aberdeen,
now one of Europe’s largest nutrition institutes, in order to
explore and promote better scientific links between farming and
health. Inclined to favour market solutions, he was gradually
convinced of the need for State action. He had conducted a
highly influential study of poverty in the 1930s,33 and concluded
that the key solution was adequacy of income: without income
above a certain threshold, people could not purchase a nutri-
tionally appropriate diet. He calculated that 50 per cent of the UK
population was unable to afford a diet deemed adequate. This
argument was taken up with vigour by campaigners for women
and families, who argued that, because it was ultimately mothers
who controlled food within homes, it was they who should be
provided with food-oriented aid and education. The post-War
changes in the domestic division of labour fuelled this view, with
women entering the labour force and acquiring disposable earn-
ings of their own, yet still retaining control over food in the
domestic sphere.
By the end of World War II, the view that income was the key
to health had triumphed in Western public policy. Yet the FAO,
established in 1945, operated primarily as a production-oriented
world body while the WHO, set up in the following year,
remained locked in a medical model of health. Boyd Orr had been
pioneering the case for better integration of health and agri-
culture for many years, and by 1945 the idea of joining health and
agriculture had already been considered by scientists from all
over the world. Such a food policy was reinforced by an earlier
Conference on Food and Agriculture in the US in 1943. During
World War II, the need to have the agriculture and health sectors
collaborate became pressing in order to confront the world’s
growing nutrition and agriculture problems (such as the legacies
of the 1930s ‘Dustbowl’ crisis and recession in the US). Boyd Orr’s
vision34 was global: feed the under-consuming parts of the globe
by unleashing the capacity of Western, and particularly US,
farmers. His was a classically ‘top-down’ perspective which
now would sit a little uneasily with our new era of community
108 FOOD WARS

participation and people-led visions: his goal, though egalitarian,

was essentially managerialist and Northern-led.
Such food policy vision lost ground after World War II,
particularly as the Productionist paradigm took hold, because,
first, the nature of production altered both on and off the land;
second, there was a radical change in lifestyles, with increasingly
affluent and less active proportions of all societies; third, with
affluence, people could eat what the food supply chain offered
them: ‘feast-day’ foods in abundance and every day.

POST-WORLD WAR II ADVANCES IN

SOCIAL NUTRITION
The modern epidemiological (that is, population-based) position
on the relationship between diet and health had a number of
progenitors. Professor Ancel Keys’ pioneering research in the
1950s showed that diet was a crucial factor in degenerative
disease patterns:35, 36 in his famous ‘Seven Countries’ study, he
noted that the inhabitants of the island of Crete suffered least
from the circulatory diseases. His data concluded that the Medi-
terranean diet was significantly healthier than the Northern, say
Finnish, diet with its higher saturated-fat intake. In fact, it is not
the Mediterranean diet alone that is so healthy, but a balance of
nutrients and social conditions.37
Dr Hugh Sinclair, today scantly remembered in the world of
public health nutrition for his work on essential fatty acids, until
his death in 1990 promoted a view that is central to this book:
namely, that the relationship between food and health requires
total food supply chain thinking.38 In 1961, he argued:

[W]e can now see clearly that the nutritional problems confronting
the world are more urgent and serious than any others. They can be
divided into two broad classes: the provision of adequate food for a
rapidly increasing world population, and the disasters caused by the
processing and sophistication of food in more privileged countries.39

Yet, decades since scientists like Sinclair and others first voiced
their concerns, strategic and policy thinking has continued to
go in a different direction. Although nutritional and scientific
 POLICY RESPONSES TO DIET AND DISEASE 109

understanding today is immensely more sophisticated than

it was a century ago, the views of people like Keys, Sinclair,
Trowell, Burkitt and McCarrison helped map a practicable view
of food and health policy in both supply chain and population
terms.40, 41 To meet their goals would require a major restructuring
of the food supply and threaten many very powerful interests,
because their arguments were rooted in – what is sometimes
called ‘social medicine’ – the pursuit of medicine for social good,
proposing that life-enhancing nutrition requires good distribu-
tion of food within and between populations, good food produc-
tion and good skills and education.
Today, social nutrition is not regarded as the cutting edge, nor
is it seen as a good vocation despite its long pedigree.42 The
academic discipline of nutrition in some respects now lacks
public links and pursues a mechanistic (or biochemical) view of
health more suited to industrial–pharmaceutical interests; it is in
the process of being captured by the Life Sciences paradigm. The
gap in the social role has tended to be filled by NGOs and food
campaigners in the Food Wars rather than by scientists or diet-
icians. Nutritionists individually and personally subscribe to the
social vision but too often they lack the sympathetic policy
networks and skills. The health crisis and the evidence of the
nutrition transition discussed in Chapter 2 should surely re-
invigorate a social vision for nutrition.

PUBLIC HEALTH STRATEGIES: TARGETING

POPULATIONS OR ‘AT RISK’ GROUPS?
Health, in the WHO’s 1946 founding charter’s definition, is ‘a
state of complete physical, mental and social well-being, and not
merely the absence of disease or infirmity’.43 While everyone
knows when they are not feeling well, many people do not
actually think about their health until they are not well or they
are reminded of the fragility of life, such as when a relative gets
ill or dies. Well-being tends to be a coping issue: we say we are
well when we can continue to do what we normally do. From a
public policy perspective, the challenge is how to deliver a state
of population health which is optimum and permanent and
which meets ecological and economic criteria. Health strategies
110 FOOD WARS

in recent years have tended to place an emphasis upon ‘at risk’

social groups: that is, people who already do not, or are likely not
to, exist in a state of well-being. Studies into CHD in countries
such as Finland, Thailand and Costa Rica have shown that
getting a dietary improvement over the whole population
improves every individual’s health.44, 45, 46 Such whole-population
approaches have the capacity to make everyone healthier while
retaining the normal diversity and range of behaviour,47 and
pushes the average health of a nation in a positive direction
(illustrated in Figure 3.2).
Targeting whole populations provides governments with
better chances of public health success, whereas targeting ‘at risk’
individuals could be socially divisive. This does not mean, as is
sometimes assumed, everyone eating the same or a bland diet,
but moving overall dietary behaviour en masse in a healthier
direction. The population approach applies the medical dictum
that prevention is better than a cure – for all citizens and not only
the ill. This is why the insights of epidemiologists on health and
disease patterns are so important. They remind us about public
population health, not just individual health.48, 49, 50

Goal of public health

strategy

% of individuals

20% 25% 30% 35% 40% 45%

fat as % of total dietary energy

Note: The bell curve represents a total population

Figure 3.2 Shifting a population in a healthier direction: a hypo-

thetical example of fat intake
 POLICY RESPONSES TO DIET AND DISEASE 111

Professor Geoffrey Rose claimed that, if high blood pressure

patients are to get well, it is best not to see them as a different
category of people but as the extension of normality; they are at
one end of the normal statistical distribution curve; there needs
to be less emphasis on their sickness than on the wider social
determinants of both the healthy and the sick, such as the prevail-
ing causes of high blood pressure. Public policy should aim to
deliver social structures that allow individuals to remain well.
This insight gives a new impetus for public policy; one which
sees health as systemic, something that can be nurtured.

DIETARY GUIDELINES AND GOALS

International public health and nutrition policy responses have
to date been limited to the drawing up of dietary guidelines and
goals for populations. These are often translated into giving
advice to the public on what constitutes a healthy diet and even
suggesting individual changes, alongside product labelling.
Dietary guidelines have been both controversial and a major
policy battle in the Food Wars, having, in theory, formed the basis
of much government and nutrition policy since the 1980s. They
may have proved extremely useful in setting goals and raising
public awareness, especially through media coverage, but on
their own they yield nothing. They need to be accompanied by
measures to change supply and to ensure that people meet the
set goals.52 This too rarely happens, and unless implemented
down the food supply chain, the guidelines remain only on
paper.
Although there were some nutrition guidelines prior to World
War II, the modern era of guidelines began in Europe with
Norway, Sweden and Finland producing the first recorded
governmental dietary guidelines in 1968, with the US following
in 1970 and New Zealand in 1971. Initially, with the Nordic
exception, these were guidelines produced by expert societies
with government approval, rather than by government itself; but
gradually most developed economy governments took respons-
ibility for their production. Once created, guidelines inevitably
have to be kept under review, given the constant shifts of both
population dietary behaviour and scientific knowledge. They
112 FOOD WARS

must also remain energetic, since reports from around the world
continue to document strong grounds for action, yet receive only
weary or inadequate policy response. In addition, dietary guide-
lines can be very threatening to certain corporate interests: to call
for a population reduction in sugar, for example, does not go
down well with the sugar industry or its main users such as soft
drinks or confectionery manufacturers. To sum up, guidelines
have to be kept under review and updated; they also need to be
linked to actual delivery in the food supply chain. That is why
guidelines can be the source of furious lobbying if they offend,
for instance, the interests of the sugar, dairy and fats trades.53, 54
Today, a general consensus exists, with relatively minor
country-by-country variations, on what national dietary guide-
lines should be.55, 56 Generally, they promote a variety of foods;
maintaining weight within an ideal range; eating foods with
adequate starch and fibre; avoidance of too much sugar, sodium,
fat (especially saturated fat) and cholesterol; and drinking alcohol
only in moderation. People are also strongly advised not to
smoke tobacco and to take regular physical exercise. Breast-
feeding and pre-conceptual care are also usually recommended.
The early editions of dietary goals were received with due
attention, while nutritionists remained alarmed by the problems
generated by deficiency diseases. The new dietary guidelines,
emerging from the developed world, encountered a certain
resistance to the idea that too much of a nutrient might be bad
for health, such as when, during the 1970s, high-fat diets came
under suspicion.57 Certain food producing sectors expressed fear
at the potential loss of economic growth, particularly industries
dependent on purveying fat, salt and sugars.
We need to distinguish carefully between recommended
dietary allowances (or intakes) and dietary goals or guidelines:
the first RDAs are the levels of intake of nutrients (for example
vitamins) considered essential, on the basis of available scientific
knowledge, to meeting the known nutritional needs of practically
all healthy persons; the second dietary goals or guidelines, more
recent than RDAs, aim to reduce the public’s risks of developing
chronic degenerative disease,58 and recommend increased con-
sumption of whole foods, foods high in dietary fibres, green
vegetables, fruit and fresh produce.59
Population-based dietary guidelines have often been con-
verted into consumer-oriented campaigns such as ‘5-a-day’,
 POLICY RESPONSES TO DIET AND DISEASE 113

pioneered in California and replicated in many countries: the

consumption of at least five portions of fruit and vegetables daily
to deliver the right mix of positive nutrients to protect health.
(The Danes argue that this ought to be ‘6-a-day’, and the Greeks,
parents of the Mediterranean diet, now recommend ‘9-a-day’.)60
Notwithstanding such specific guidelines, the focuses for policy
and industry should be on quality, methods of production and
processing and overall balance. These are such sensitive matters
for the food supply chain that it is no wonder that dietary advice
to consumers has been subject to vigorous lobbying and counter-
attacks by certain parts of the food industry.

THE DIETARY GUIDELINES BATTLE IN THE US

The first edition of ‘Dietary Goals for the United States’, pub-
lished in 1977, serves as an example of the degree of controversy
that dietary guidelines have attracted and has been described as
a ‘revolutionary document’.61 Its brief was to set quantitative
target levels for reducing fat, saturated fat and cholesterol in the
American diet, and the publication created a storm of protest and
polarized professional opinion (despite the approval of many of
the principal US researchers on diet and atherosclerosis).62 It was
variously seen as being premature; inadequately researched;
politically motivated; promising too much; unreliable; puritanical;
‘big-brother ’-ist; and engendering a ‘nutritional debacle’.
Predictably, then, by the end of 1977, a second and revised edition
of the ‘Dietary Goals’ had been published, including a foreword
which included the following disclaimer: ‘The value of dietary
change remains controversial, and science cannot at this time
insure that an altered diet will provide improved protection from
certain killer diseases such as heart disease and cancer.’
The ‘Dietary Goals’ then, while never an official document,
remained in circulation and drew public as well as professional
attention to the need for national (and international) guidance on
diet and health. For the first time, the American consumer was
being called upon to make both quantitative decisions (how
much food to eat) and qualitative choices (choosing some foods
over others). Despite its deficiencies, it served to divide scientific
opinion between those who believe in a ‘targeted’ approach
114 FOOD WARS

aimed at those identified as ‘high risk’, and those who believe

in a ‘population’ approach geared towards general health-
promoting behaviours including changes in diet.63 By early
1980, US nutritional advice was given official credibility with the
publication of ‘Nutrition and Your Health: Dietary Guidelines for
Americans’, by the US Departments of Agriculture and (then)
Health, Education and Welfare, which is now reviewed and
republished at five-yearly intervals.
Acceptance of the national dietary guidelines by many
US food producer interests has been hesitant. For example,
the US Department of Agriculture (USDA), has consistently
promoted diets that ‘emphasize consumption of foods from
animal sources’;64 lobbying also came from the meat and dairy
producers. Its 1992 revised guidelines, the ‘US Food Guide
Pyramid’, suggested eating less meat. Commercial interests
exerted considerable energies in undermining dietary advice
from the Surgeon-General’s department, while bolstering the
Productionist mentality of the Department of Agriculture.65
In the UK, near-identical battles have been documented.66
Indeed, the last two decades of the 20th century saw food-
industry attempts to stifle health education through dietary
guidelines.67, 68 Even in Scandinavian countries, with their
relatively advanced and integrated nutrition policies, industry
resistance to dietary advice has been fierce, and progress in
implementing the Norwegian nutrition policy of 1976, for
example, was slow. Yet Norway seems to have a more integrated
food and nutrition policy which has tried to balance the interests
of agriculture, fisheries, the consumers and trade as well as of
education and research. This is despite initial resistance from the
dairy and meat industry, who tried to subvert the policy by
producing ‘expert evidence’ that milk, butter and other dairy
products posed no risk factors for CHD onset.69
Not all sectors of the food industry are threatened by guide-
lines; some indeed have responded positively by creating a
multi-billion dollar market for ‘healthy eating’ products, albeit
targeted at and premised on an individualized notion of health.
However, dietary guidelines have been a rallying point for a new
generation of health activists who saw little point in encouraging
health education if an avalanche of consumer product choices
made it hard to follow.
 POLICY RESPONSES TO DIET AND DISEASE 115

THE CASE AGAINST THE WESTERN DIET

By the end of the 1980s, eminent nutritional commentators such
as Professor Nevin Scrimshaw were able to conclude: ‘After years
of controversy, a remarkable degree of consensus has developed
regarding the kind of nutritional goals most likely to promote
good health.’70 The general ‘consensus’ on nutrition and public
health can be summarized in the following statements:

l During the last half-century, Western diets have become

unbalanced. They now contain too much fat in general, too
much hard, saturated fat in particular, too much sugar and
salt, and not enough fibre.
l Translated from nutrition to food, a healthy diet is rich in
vegetables and fruit; bread, cereals (preferably wholegrain)
and other starchy foods; and may include fish and moderate
amounts of lean meat, and low-fat dairy products.
l The best diet to reduce the population risk of heart attacks is
the best diet to protect against obesity, diabetes, common
cancers and other Western diseases, and is also the best diet
to promote general good health.71

However, even though there may be a consensus at public policy

level, the scientific debates persist. For example, while dietary
guidelines target high intake of fat as an unhelpful component
of the Western diet, some scientists argue that the relationship
between dietary fat and adiposity, or any other health outcome,
is uncertain; breads and cereals advocated as part of a prudent
low-fat diet may actually have significant negative effects in an
environment of energy abundance, due to their high glycemic
index.72 Further, Professor Marion Nestle has claimed that US fat
production by farmers is still excessive and that, once produced,
will somehow make its way down consumers’ throats.73 So even
if consumers resolve to reduce their fat intake, it may still feature
in their diets via hidden routes – in processed foods, when eating
out or ‘on the hoof’; food processors may invent ‘low-fat’
products merely to jostle the shelves alongside a plethora of
products bursting with hidden fats.
The European Union contains Member States which featured
in Ancel Keys’ original work as representing both the best (Crete)
116 FOOD WARS

Table 3.1 The Eurodiet Project population guidelines, 200074

Component Population goals Levels of

evidence
Physical activity levels (PAL) PAL >1.75 ++
Adult body weight as BMI (body
mass index) BMI 21–22 ++
Dietary fat as % of total energy <30 ++
Fatty acids, % of total energy
Saturated <10 ++++
Trans <2 ++
Polyunsaturated (PUFA)
n-6 4–8 +++
n-3 2g linolenic + 200mg ++
very long chain
Carbohydrates, total % of energy >55 +++
Sugary food consumption,
occasions per day <4 ++
Folate from food, micrograms
per day >400 +++
Dietary fibre, grams per day >25 ++
Sodium, expressed as sodium
chloride, grams per day <6 +++
Iodine, micrograms per day 150 (infants: 50; +++
pregnancy – 200)
Exclusive breastfeeding About 6 months +++

and worst (Finland) national case studies of diet and health. It is

a matter of some urgency, therefore, that the EU at least considers
homogenizing its diet policy to prevent drifts from the best- to
the worst-case dietary scenarios. To this end, the European
Commission decided in the late 1990s to initiate a project known
as ‘Eurodiet’ to bring together experts in food and nutrition from
all Member States to draw up guidelines for nutrition across the
EU. Eurodiet worked for two years with a final meeting in Crete
in 2000, and its recommendations (Table 3.1) suggest that the
attainment of nutrient goals for fat, saturated fat, dietary fibre,
complex carbohydrate and many vitamins and minerals would
 POLICY RESPONSES TO DIET AND DISEASE 117

require an overall reduction in the consumption of meat and

dairy produce and an increase in consumption of plant-based
foods, particularly vegetables and fruit.

A NEW APPROACH TO THE RELATIONSHIP

BETWEEN FOOD, DIET AND HEALTH
Building on the experience of creating guidelines and the frustra-
tions of implementing them, some policy-makers are increasingly
looking to link guidelines to the food supply chain in a more

Strategic planning and implementation

Strategic planning and implementation

Health impact
impact
SECTORS:
Health
assessment ofof Regulatory
Regulatory
assessment SECTORS:
food-related instruments
Instruments
food-related Public
Public health
health
policies Environmental protection
Environmental protection
policies
Agriculture
Agriculture
Horticulture
Horticulture
Food industry
retailers
Food Industry
Food and health Enforcement
Food and health
Tourism
Food retailers Enforcement
information
Information
Voluntary
Tourismsector
The public
Voluntary sector
The Public
Professional
Professional
Research and education
education and
training
development
development and training

Economic
Economic Mass
Mass Informationand
Information and
instruments
instruments media &
Media & healtheducation
health education
marketing
Marketing

Source: WHO, The First Action Plan for Food and Nutrition Policy, European Region
of WHO, 2000–2005, Copenhagen, WHO Regional Office for Europe.

Figure 3.3 An integrated approach to food, nutrition and health

118 FOOD WARS

meaningful way. What is their point if they are not enacted?

There is a need to ensure greater transparency on committees,
the curbing of commercial funding and the tackling of vested
interests. This is a political battle. The approval of politicians
needs to be won, if the formal levers of state influence are to be
pulled in the public health’s favour.
Internationally, there has been much effort to create a positive
food policy consensus. The European Region of the WHO
representing 51 countries, not just the European Union, has been
pioneering an integrated approach to food, nutrition and health
embracing the whole food-supply chain, as illustrated in Figure
3.3. The nutrition division of the WHO Europe argues that food
policy should not only entail nutrition and food safety, but also a
sustainable food supply. Delivering health, it believes, requires
partnership.75, 76 This is a unique and ground-breaking policy
approach which requires the WHO and the FAO (sometimes
idealogically divergent organizations) to work together. It is an
international approach to food and health that is long overdue.77
At the global level, in 2000 the WHO also embarked on a
major revision of its world guidelines, previously produced in
1990. Its ‘Diet, Nutrition and Chronic Disease’ report was in 1990
a major policy advance, issuing the first modern set of dietary
guidelines, incorporating epidemiological data, compiled from
numerous studies and guidelines at national level.78 A 2003 vision
retained the same title but was, significantly, jointly produced
with the FAO and gave new guidelines for each major disease –
from heart disease to osteoporosis and bone fractures.79 Just as
importantly, it was accompanied by a wider-reaching consulta-
tion exercise (2002–2004) involving consumers, the food industry
and health professional organizations, and leading, hopefully, to
global implementation and political backing with effect from
2005.80, 81
This innovation is promising. After a stormy history, public
health nutrition and policy could be on the brink of a new era. A
new, more integrated policy approach could be emerging in
intergovernmental and national circles. But the ground-breaking
work of the WHO, either globally or regionally, is only as strong
as its national take-up. The WHO and the FAO are Member State
organizations; they may have moral authority but little economic
or political clout. The success or otherwise of the WHO and
others in effectively developing and implementing measures
 POLICY RESPONSES TO DIET AND DISEASE 119

towards a more integrated global food policy will be one of the

major battles of the Food Wars over coming years.
At the heart of the war over health, then, is a policy choice
between individual or population focus. (Some key features
of these different approaches are summarized in Table 3.2.) All
three paradigms have features which lend themselves to both
individual and population perspectives, but the social policies

Table 3.2 Individualist and population approaches to food and health

Policy focus Individualist public Population public

health approach health approach
Relationship to Trickle-down theory; Health as economic
general economy primacy of market determinant; public–private
solutions; inequality partnerships; inequalities
inevitable requiring societal action

Economic direction Individual risk; personal Social insurance including

for health policy insurance; reliance on primary care, welfare and
charity public health services

Morality Individual responsibility; Societal responsibility

self-protection; based on a citizenship
consumerism model

Health accountancy/ Costs of ill health not Costs internalized where

costs included in price of possible
goods

Role of the state Minimal involvement; Sets common framework;

resources best left to provider of resources;
market forces corrective lever on the
imbalance between
individual and social
forces

Consultation with As consumer; dependent Citizenship rights;

the end user on willingness to pay authentic stakeholder

Approach to food The right to be unhealthy; The right to be well; entire

and health individual choice; demand food supply geared to
will affect supply; niche delivering health
markets
120 FOOD WARS

which infuse nutrition, as we have seen above, pull the para-

digms in one direction or the other. This, too, is a political struggle.
Although the Life Sciences Integrated paradigm is heavily sub-
scribed to by corporate interests offering an individualist
approach to health, we believe that this paradigm requires a more
population-oriented focus is required. The Ecologically Integ-
rated paradigm, by contrast, is more rooted in a social or
population approach but it too has individualistic tendencies. In
the next chapter we outline the role of food business, the emerg-
ence of powerful food companies within and across borders, and
we explore tensions between diverse sectors that will settle the
shape of these paradigms with regard to health. This will help
shape how relatively individualist or population-focused the
paradigms become.

OBESITY: A CASE STUDY OF BATTLES OVER

POLICY RESPONSES TO A PROBLEM
In this chapter we have sketched out the long struggle to inject
nutrition into food policy and to bring food into the wider public
health arena. There has been a bitter war over how food and
health are not just matters of deficiencies and an absence of food,
but also problems of inappropriate eating and a warped food
supply.
The current obesity epidemic symbolizes the ongoing battles
within nutrition policy – battles over targeting population versus
‘at-risk’ individuals, the delicate balances between government,
commercial and ‘consumer’ responsibilities, and ‘medicalized’
versus ‘social’ nutritional approaches to policy.
Probably above all other diet-related diseases that we out-
lined in Chapter 2, obesity has become the main issue in public
discourse now spearheading the case for a return to policy
solutions grounded in social nutrition. That said, medicalized
solutions to obesity are also being promoted from within the
scientific community and industry – for example, solutions such
as ‘designer foods’ for ‘weight management’, supplements and
drugs, as well as full-scale surgical interventions, such as stomach
stapling.
The proponents of social nutrition argue that public policy
ought to consider, among many actions, taxes (to alter food price
 POLICY RESPONSES TO DIET AND DISEASE 121

signals), transport policy (to build physical activity into daily

life), schooling (to give positive messages at an early age)
and controls on marketing, advertising and sponsorship (to
protect people from unbalanced education). The middle ground
is shared by the need to re-think the rights and responsibilities
of industry, the state, consumers and key influences such as
parents and schools, and particularly by the need to address the
issue of overweight and obese children.
But almost all debates within public policy end up by having
to face the wider social issues that frame obesity and help to
explain why it has emerged so fast in evolutionary terms: what
has created the obesgenic environment?

PUBLIC POLICY RESPONSES TO OBESITY

Across the obesity debate, policy responses are widely seen to
lack integration.82 In countries throughout the world, there is now
public vocalization of the extent of the problem. Evidence has
mounted; TV programmes and public health reports have been
written; ‘wonder diets’ and products for losing weight have been
promoted; government ministers and health professionals have
all agreed on the extent and significance of the problem. For
example, in the UK, the normally restrained chief medical officer
called obesity ‘a health time bomb with the potential to explode
over the next three decades . . . unless this time bomb is defused
the consequences for the population’s health, the costs to the
NHS [National Health Service] and losses to the economy will
be disastrous’ and the UK’s Food Standards Agency was urged
to ‘alert consumers to the risks of regular consumption of
foods high in calories, fat and sugars’.83 The UK Parliamentary
Health Committee also launched an inquiry into obesity.84 In
countries across the globe, similar processes were underway,
with inquiries, calls for evidence and new action plans being
created. In Norway, for instance, the long-established Nutrition
Council was given a new emphasis to look at diet (input) and
physical activity (output),85, 86 and in Sweden a national working
party was set up, charged to produce a new national policy and
action plan.87, 88 In the US, the Surgeon-General produced a hard-
hitting assessment of the obesity crisis.89
122 FOOD WARS

The conventional policy reflex to offer single solutions for a

single problem clearly does not fit the etiology of obesity that
lends itself to multifaceted solutions. Key policy tensions in the
obesity debate have centred around:

l environmental versus genetic causes;

l targeting ‘at-risk’ people versus a population approach;
l the relationship and roles between corporate versus public
spheres;
l the relative importance of diet versus physical activity;
l fostering ‘real’ change versus public relations approaches to
health education;
l government’s role: the ‘hands-on’ versus the ‘hands-off’ state;
l people’s responsibility: are they simply consumers or ‘food
citizens’?;
l agriculture and the food industry producing and marketing
inappropriate foods and beverages.

As a result of tensions over these issues, and the inevitable

sectoral jostling for policy position and influence, there is often
no clear-cut or uncontested set of policy options and inter-
ventions. Nevertheless, two distinct packages of policy options
have emerged. These illustrate the key themes in this chapter,
not least individual versus population policies and social
versus biochemical approaches to nutrition, in keeping with the
paradigms. Political pragmatism – governments trying to be
even-handed and not to offend too many powerful interest
groups – means that elements of both are likely to be cherry-
picked. The packages’ differences, however, are important.
The individualized policy package on obesity includes:

l individual responsibility to chose ‘healthier’ or ‘unhealthy’

options;
l product branding and market solutions;
l healthy food options (but costs?);
l technical fix: ‘designer’ foods, supplements, drugs;
l genetic screening;
l gyms for those who can afford them.

The population policy package for obesity includes:

 POLICY RESPONSES TO DIET AND DISEASE 123

l addressing educational needs;

l regulatory measures, such as food labelling and advertising;
l food assistance programmes;
l health care and training;
l transportation and urban developments;
l taxes;
l governmental policy development;
l changes in food supply chain.

INDUSTRY RESPONSE
After years of publicly ignoring or denying its role in obesity
generation, the food and beverages industry has been brought
to account by the rapidity of worldwide public outcry over
obesity.90 It has known the evidence about the problem of obesity
for decades, 91 but has tended to expect that it could be dealt with
by the diet industry and within the dominant policy model of
individualized choice and market forces.
The obesity issue is now, however, changing the food
industry’s nutritional landscape. The food industry is facing
increasing scrutiny over the food and beverages that it produces
and there has been a raised risk of increased regulation of
advertising, labelling and marketing, notably in Europe. The
threat of litigation over obesity in the US, akin to tobacco-style
legal actions, has raised the policy temperature.92
But this legal threat to US industry interests seemed to have
been overcome when the US House of Representatives passed a
bill on 10 March 2004 stating that overeating is a problem for
individuals, not the courts. The new legislation, formally known
as the Personal Responsibility in Food Consumption Act, bars
new cases and dismisses pending federal and state suits in which
damages are sought as compensation for conditions connected to
weight gain or obesity attributed to restaurant food. But the bill’s
authors said that it would not prevent suits brought because of a
restaurant’s negligence, false advertising, mislabelling or tainted
food. In endorsing the bill, the White House said in a statement:
‘Food manufacturers and sellers should not be held liable for
injury because of a person’s consumption of legal, unadulterated
food and a person’s weight gain or obesity.’93
124 FOOD WARS

But the industry is still torn between being defensive about

its existing business operations and product offerings, and seeing
obesity as a massive new business to produce weight manage-
ment products targeted at the obese and those suffering diseases
associated with obesity, such as diabetes. To give one example,
Nestlé, the world’s largest food company, in a presentation given
to financial analysts in London on obesity in September 2003,
outlined its strategy of how it was dealing with ‘health and
wellness’ in the context of ‘weight management’. Its presentation
indicated a subtle shift in Nestlé’s thinking about its product
range to address weight-management market issues.94
Examples of Nestlé’s thinking on weight management in
terms of adding value to products ranges from ‘reassurance’
(such as portion control: claims such as ‘contains one serving of
vegetables’) to ‘healthier ’ (such as ‘lower in saturated fat’),
through to what Nestlé describes as ‘active’ (for example, weight
and cholesterol control). Product development built around
health and well-being, from Nestlé’s perspective, involves com-
bining food attributes (such as structure, ingredients, safety, taste,
texture, flavour, aroma, satiety and appetite) and matching these
to consumer health needs built around the health effects of
particular foods or food ingredients, as well as targeting inter-
individual differences related to diet and health.
Nestlé summarized its position on obesity thus: proper
nutrition and adequate physical activity are integral to main-
taining good health; every food has a role to play in achieving a
balanced diet. The company also stated that it is committed to
responsible communication about all its products, especially
those consumed by children, and to clear and user-friendly
nutrition labelling. The company plans to encourage nutrition
education programmes for the public and to collaborate with
public health bodies in both national and international efforts
to reduce the incidence of global obesity. Key phrases for Nestlé
are apparently now to be ‘better taste = better nutrition’ and ‘easy
choices = healthy choices’.
Nestlé is not alone in taking such a position. Other major
global companies such as Kraft, Burger King and McDonald’s
have also reviewed their product portfolios in terms of portion
size, composition, labelling, and marketing and advertising
practices. Many companies are rapidly addressing the ‘obesity
risk’ to their product portfolios built around fat and sugars, but
 POLICY RESPONSES TO DIET AND DISEASE 125

also focus on business development and innovation efforts on

higher-margin nutritional foods.
In all of these cases, part of the food industry’s response is
to engage and be proactive with public policy to tackle obesity.
But it is not a united front. Other sectors of the food industry
have taken a different approach and embarked on an aggressive
attack against public policy strategies aimed at addressing diet
and chronic disease. One of the most high-profile examples of
this new open warfare against public nutrition policy has been
by the US sugar industry and its response to the World Health
Organization (WHO) strategy to help combat the worldwide
problem of obesity.95, 96
This situation is rapidly changing and the battles over obesity
have the potential to transform the food and health policy land-
scape, possibly in a radical way. They could open up a new
awareness and unleash public concerns even further about what
is good nutrition. This might herald a rebirth of policy shaped by
social nutrition; but, as the brief history of nutrition policy
outlined in this chapter has shown, this is likely to be a continu-
ing rather than a quick battle.
126 FOOD WARS

CHAPTER 4
THE FOOD WARS
BUSINESS
‘Take care to drive your cow gently, if you want to milk her comfortably.’

Catherine the Great, Empress of All Russia (1729–1796)

CORE ARGUMENTS
Historically, central focuses of government policy have
been agriculture and the facilitation of agribusiness, these
industries forming the cornerstone of the Productionist
paradigm. But today, in the newly evolved food economy,
farming is no longer the driver it was; agribusiness,
adding value to raw foods, has become more powerful.
The consumption end of the food supply chain, namely
retailing, food service and branded food manufacturers,
increasingly dictates the terms and conditions of the
consumer food market war; they are the brokers for the
future but are not in consensus on any one vision for food.
Collectively, corporate powers have consolidated both
internationally and throughout the food supply chain, and
it is corporate policy, as much as public policy, which is
now shaping food policy agendas.

THE BATTLE FOR COMMERCIAL SUPREMACY IN

THE FOOD SYSTEM

This chapter explores five key issues raised by the contemporary

evolution of the food business:
 THE FOOD WARS BUSINESS 127

1 Corporate power is now so great within and between

national borders that it is redefining what is meant by a
‘market’.
2 Food companies now have an increasing interest in health
which they apply to marketing and product development,
despite the decades spent resisting nutrition policy analysis.
3 There are tensions within the corporate sector over how
to approach and deliver health, in part driven by intense
business competition.
4 Today’s food system is radically different from that of the
past: it is fast evolving and full of risks.
5 Corporate policy is becoming more fully engaged in public
policy to further its own interests and thus raising questions
about accountability.

At the heart of the food economy is the way food and beverages
are manufactured and processed. A feature of food manufactur-
ing is its relative conservatism in the sense that many of today’s
leading manufacturers, such as Nestlé, Coca-Cola, Cadbury and
many more, have their origins in the 19th century or early 20th
century. With products 50, 60 or even more than 100 years old,
some companies could be said to be anachronistic, but the food
industry, as a combined sector, as formidable in its range as it is
in its influence. It lacks, however, common goals and objectives.
In this chapter, we explore the war for supremacy in commerce
over food supply by detailing the key links in the food chain and
how they are changing, arguing that, for it to provide a health-
centred food supply, the food industry itself must undergo a
fundamental rethink. We foresee increasing tensions within and
between the food sector and food companies over how to address
the issues captured by our three-paradigm model: currently the
Life Sciences Integrated paradigm is being heavily promoted and
major policy battles are being fought between it and the Produc-
tionist interests; nibbling away at both are the increasingly
articulate proponents of the Ecologically Integrated paradigm.
The Productionist paradigm is reaching the peak of its power,
with global corporate ‘clusters’ now dominating food supply
while at the same time having to address a continuing stream of
food crises and to implement far-reaching strategies of risk
management. These giant clusters are locked in competition
between themselves out of which they are adopting two key
128 FOOD WARS

strategies: the first is a reliance on technology to resolve most

problems; the second is alignment of their interests closer to the
consumer. Often the two strategies are not mutually compatible:
the pursuit of technology (such as genetic modification) is often
in conflict with consumers. A newer model of the food economy
is centred on technical manipulation, branding (emotional
manipulation) and the rise to supremacy of the food retailing and
food service industries. (Figure 4.1 summarizes some of the main
battlegrounds in the war for commercial supremacy, and how
these fit into the paradigmatic model outlined first in Chapter 1.)
These key battlegrounds include:

l whether to intensify or extensify production methods;

l how to consolidate market shares and beat the competition;
l how to promote food business growth and development –
through internal revenue generation (organic growth), or
acquisitions and mergers, or cost-cutting and productivity
efficiencies;
l how to expand internationally while still delivering business
success locally and nationally;
l which new products and markets to develop;
l the best business strategy with regard to mergers and acquisi-
tions, core competencies, investment processes (returns-on-
investment) and geographical control;
l how to move from a primary commodity (or production-led)
mentality to a consumer market-led approach and business
culture.

THE ORIGINS OF THE INDUSTRIAL

FOOD SUPPLY
Finding and producing food has been central to the whole saga
of human survival and cultural evolution. Homo sapiens has been
foraging for food for more than 100,000 years; has farmed it for
10,000 years; and has probably manipulated the environment
(not farming per se) for considerably longer. But people have
been farming and processing food industrially on a mass scale for
mass markets across a high proportion of total diet for only 200
years. Now human society is gearing up to change the ancient
 THE FOOD WARS BUSINESS 129

Life Sciences
Integrated
paradigm

Productionist
paradigm

Which
direction
for food
business?

Ecologically Integrated
paradigm

Key Battlegrounds in the Food Business Wars:

l Intensification vs extensification
l Concentration and competition
l Market share
l New products
l Marketing methods
l Business strategy
l Mass vs niche products
l Primary commodity vs consumer-led
l Technology adoption
l Globalization & global sourcing
l Retailer power

Figure 4.1 Food industry within the paradigms

and historic genetic make-up of both farm animals and crops in

the belief this will secure future food supplies.
The modern food economy has been fed by unprecedented
changes in human population growth and demographics. In
particular, the decades since the end of World War II have seen
130 FOOD WARS

4.2a United States (1995–1997) Note: US caloric consumption

per person is up 20% since
Sugar &
Milk & dairy the early 1970s to the world’s
10% highest – a third above the
sweeteners
18% global average. Although the
Meat & poultry
16% US menu reflects the variety
Starchy roots & typical of industrialized
pulses
4%
countries, it’s lower than the
Other industrialized country average
Fruits & vegetables 6% in cereals and higher in
5% meats, sugar and sweeteners
(such as found in soft drinks)
Veg oils & and dairy products.
animal fats Cereals
18% 23%

4.2b European Union (1995–1997) Note: Despite a taste for

sausages and cheeses,
Sugar & Europeans consume fewer
sweeteners calories than Americans, and
11% Milk & dairy diets more closely mirror
9% industrialized country
Starchy roots & Meat & poultry
pulses 14% averages. Compared with the
5% United States, cereal
Fruits & vegetables consumption is higher,
Other though down since the 1970s
6%
9%
compared to the US trend.
Veg oils &
Diets have less sugar, but
animal fats nearly 7% of calories come
21% Cereals from animal fats, twice the
25% US level.

4.2c Latin America & Carribean (1995–1997) Note: Among major

developing regions, Latin
Sugar & America shows the least
Starchy roots & sweeteners overall dependence on
pulses 17%
8%
cereals and the greatest
Milk & dairy apparent dietary diversity.
6% Since the early 1970s,
Fruits & vegetables consumption of cereals and
6% Meat & poultry starchy roots and pulses has
11% decreased, and diets now
Veg oils & Other
3%
include more meat and
animal fats
poultry, sugar and
12%
sweeteners, dairy products
Cereals
and vegetable oils.
37%

Souce: http://fas.usda.gov/info/asexporter/2000/Apr/diets/htm

Figure 4.2a–f Diets around the world – proportion of energy derived

from different foodstuffs determined by different regions’ relative stages
of development
 THE FOOD WARS BUSINESS 131

Note: Rising incomes and 4.2d Developing Asia (1995–1997)

farm production have altered
diets and steadily lifted this Starchy roots &
Fruits & vegetables
region’s caloric consumption. pulses
Veg oils & 4%
6% Sugar &
Although rice and other animal fats
sweeteners
cereals still account for 60% 8%
6%
of calories, that’s down from
Milk & dairy
67% in the early 1970s. The 2%
role of starchy roots and
Meat & poultry
pulses has been halved, while
Other 7%
the share of calories from
7%
meat and poultry more than
Cereals
doubled. 60%

Note: Oil revenues have 4.2e North Africa (1995–1997)

helped North African
countries such as Egypt. Starchy roots &
Fruits & vegetables
Libya and Algeria boost pulses
6%
Veg oils & 4% Sugar &
average calorie consumption
by nearly 40% since the animal fats sweeteners
10% 9%
1970s. Cereals remain the
primary source of calories, Milk & dairy
but cereal consumption has 3%
dropped slightly, while the Meat & poultry
share of calories from most 4%
other food groups has Other
Cereals 2%
increased.
62%

Note: In this generally poor 4.2f Sub-Saharan Africa (1995–1997)

region where tens of millions
are chronically Starchy roots &
undernourished, daily per pulses
24% Sugar &
capita consumption was Fruits & vegetables sweeteners
2176 calories in 1995–1997, 5% 4%
Milk & dairy
20% below the global
2%
average. Cereals and roots Veg oils &
still provide 70% of calories. animal fats
9% Meat & poultry
More costly foods that would 3%
add variety and nutrition are Other
consumed at some of the 7%
world’s lowest rates.

Cereals
46%
132 FOOD WARS

exponential growth in the human population and in our methods

to feed ourselves. At the same time world average life expectancy
has doubled. Demographic transitions, from rapidly ageing
populations in developed countries to the international mix of
affluent food consumers, are also having an impact on the food
economy. Since the 1950s, proportions of people living in cities
increased fivefold from around 10 per cent to 50 per cent; and for
the first time in human history the urban population will exceed
the rural. Within 50 years, water consumption and global food
yields have increased sixfold.
Over the same time-span, consumption of starchy staples has
decreased from around 25 per cent or less of total food energy,
and fat consumption has increased to 40 per cent.1 Figure 4.2
illustrates how the proportions of energy derived from different
foodstuffs vary between continents suggesting their relative
stage of economic development. At one end of the dietary
spectrum is the US where cereals account for 23 per cent of
dietary energy, sugars 18 per cent and meats 16 per cent; at the
other end is North Africa where cereals account for 62 per cent of
dietary energy, sugars 9 per cent and meats just 4 per cent. During
the past 200 years of industrialization, average individual
levels of fat and refined sugar in Western society have increased
fivefold and 15-fold respectively due to all-year-round supply of
foods.3
With growing populations and more mouths to feed, espe-
cially affluent ones in the developed world, nationally dominant
food and beverage companies have experienced near un-
interrupted economic growth and dividend payments for their
shareholders. This steady stream of profits and income came
under increasing pressure during the 1980s and 1990s, with many
food businesses struggling to produce the same levels of growth
as in the past, as a new era of mass mergers and acquisitions,
industry restructuring, and supermarket power emerged.
Today, the traditional food terrain is fracturing with some
interests remaining firmly in the old Productionist camp, while
others are marching towards the Life Sciences Integrated para-
digm and yet others are turning to the Ecologically Integrated
paradigm in their commitment to producing the real health
benefits for the planet, societies and for individuals. For example,
the German Federal Minister for Agriculture and Consumer
Affairs, Renate Kunast, has called for an ‘extensification’ of food
 THE FOOD WARS BUSINESS 133

production in place of the ‘intensification’ model,2 in 2002 the

British government created the Curry Commission into the
Future of Farming and Food also proposed the extensifica-
tion of UK agriculture.3 Such moves have split opinion about
the future of farming, with some seeing a drive for ever more
hi-tech farming, and others seeing extensification as a way of
getting farmland taken out of production. Either way, the British
Chancellor of the Exchequer gave an additional £0.5 billion to
implement the Curry Commission’s recommendations. At the
same time, the European Commissioner for Agriculture, Franz
Fischler, announced radical plans to switch funding and support
away from commodity regimes towards more support for envir-
onmental and rural development.4 All this change in the direction
of agricultural policy followed the unprecedented series of
scandals over food quality and confidence in the 1990s, culmina-
ting in the 1996 crisis when BSE was shown to have ‘jumped’ to
humans.
This major period of change for the food system has been
driven by wider economic forces which include:

l changes on the land which are transforming what agriculture

produces and how;
l a rapid industry concentration of control over the food chain;
l labour-shedding and restructuring;
l changes both in the scale and technology of food factories;
l a new emphasis on product development, branding and
marketing;
l new levels of control by food retailing and service over the
rest of the food economy.

The implications and lessons of these structural changes for

public policy are considerable. Public policy often lags behind the
restructuring taking place in the food system and is largely
reactive; companies are often more ambitious than politicians
about the health of individuals; captains of industry are often
clearer about the challenges to public policy. In some respects this
is to be welcomed, but some of the changes being imposed on
agriculture are now largely tailored to the powerful food manu-
facturing and retail sectors which are content to source foods
from anywhere in the world at the expense of their national
producers.
134 FOOD WARS

WHY ‘HEALTH’ IS IMPORTANT TO THE FOOD

INDUSTRY
There has in the last two decades been an emergence of what the
food industry calls ‘nutraceuticals’ or functional foods which
offer health benefits beyond basic nutrition.5 In the developed
world the onus is very much on the individual consumer to
choose these functional food options to help prevent or restrict
diseases. To this end the food industry has developed its own
health and nutrition agenda upon: heart health (in particular
cholesterol-lowering products), gut health (to keep the microflora
of the human gut in balance) and bone health (a raft of products
fortified with calcium); ‘energy’ products; and foods and
beverages fortified with vitamins and minerals. Of course, the
reality is that no disease condition or human ailment is more
immune by food product development or dietary supplement.
Many of these nutraceuticals (‘functional foods’) require daily
consumption over prolonged periods of time in high quantities
to deliver similar results to those achieved in clinical trials on the
bioactive ingredients, and they constitute a health strategy which
is counter-intuitive to modern consumer culture already
saturated with food choices and messages The health efficiency
of such products to long-term health is not established, and many
functional foods usually represent merely a short cut to new
markets and big profits. In fact, some consumer advocacy groups
have already highlighted the potential for fraud for these types
of product, warning, for example:

Fortifying conventional foods with physiologically active substances

might sometimes be appropriate, but the unbridled marketing in the
United States of about $12 billion worth of dietary supplements
annually shows the potential for defrauding and sickening consumers.
The spread of such mischief to the far larger food industry could prove
disastrous. The composition of, and advertising claims for functional
foods should be governed by judicious government regulations, not
by corporate marketing strategies.6

Despite many examples of successful ‘functional’ foods and

beverages driving this market for products with enhanced health
benefits (such as the popularity in the US and UK of soy milk,
‘nutrition’ bars and dairy-based products containing ‘live’
 THE FOOD WARS BUSINESS 135

bacteria) and the ‘promise’ that new GM varieties will provide

vaccines (‘golden’ crops) with added vitamins or other health-
enhancing bioactive substances,7 the ethical and practical
implications behind this new ‘health revolution’ are very rarely
addressed. A key issue is whether food businesses alone can or
should deliver long-term health benefits to individuals or popu-
lations, especially in such ad hoc, unevaluated and unproven
ways.

THE CHANGING CONTEXT FOR THE GLOBAL

FOOD ECONOMY
Analysis of the food economy is subject to differing inter-
pretations when viewed from particular economic perspectives.
Traditional agricultural economics relies for its sustenance on
demand and supply curves, price mechanisms and consumers’
willingness to pay for such benefits as food safety or nutritional
ingredients. However, this analysis and approach has been
confronted by the global nature of food safety crises, consumer
unease, and estimates of externalized costs for health and
environmental burdens. These are now an incentive for business
to change.
The UK BSE epidemic of the 1980s and 1990s, for example –
though famously described by the then UK Agriculture Minister
as a ‘peculiarly British affair’ after publication of the BSE enquiry
report in 1999 – quickly became a concern for countries around
the world: Japan, reported its first case of BSE in 2002, and in
Germany, France and Italy, enough cases were discovered for
beef sales to be halved within days.8, 9, 10 More general public
concerns about genetic modification and chemical use in food
production have also served to raise awareness of major prob-
lems inherent in methods of food production.

Ecological imperatives

According to some predictions, the ‘health’ of our food supply is

now in immediate danger. Lester Brown, president of Earth
Policy Institute and founder of the Worldwatch Institute, for
136 FOOD WARS

instance, has spelt out some of these dangers in his book Eco-
Economy,11 where he argues that food production has risen on the
back of unsustainable use of inputs. On the positive side, since
the 1950s: world grain production tripled; world production
of beef and mutton increased from 24 million tons in 1950 to
65 million in 2000; and growth in the oceanic fish catch climbed
from 19 million tons in 1950 to 86 million tons in 1998. On the
down side, inputs also grew to match the production of food: for
example, world fertilizer use rose from 14 million tons in 1950 to
141 million tons in 2000. Such food gains will no longer be
sustainable if based on past production methods which fail to
take global population expansion into account.
Brown sees the very foundations of food production as being
in danger. He cites:

l falling water tables, especially in key areas of agricultural

production;
l the deterioration of rangelands which supply most of the
world’s animal protein;
l soil erosion, loss of topsoil and the continuing destruction of
croplands; and
l the collapse of global fisheries.12

Alongside this pessimistic interpretation of global food and

ecological health trends, there also exists a more optimistic
interpretation. Professor Tim Dyson of the London School of
Economics, while foreseeing huge challenges ahead, argues that
grain production, for instance, can keep up with demand.13 We
are not yet sure. Per capita grain production has peaked and is
declining (see Figure 4.3). Optimists argue that the 40 per cent
rise in soya during 1960 to 2003 compensates, but much of this
goes to animals, certainly from US production. Some others
argue that one of the key values of biotechnology is its capacity
to deliver conservation as a means of addressing ecological
degradation and to increase output to meet population growth.14,
15

An extreme example of the need for the radical reshaping of

food systems by putting ecological health limits in place was the
collapse of the Newfoundland cod fisheries due to industrial-
scale fishing, which resulted in processing factories being closed
and tens of thousands of workers being laid off. More than ten
 THE FOOD WARS BUSINESS 137

Global production of grain (paddy rice) +soy (kgs/cap)

390

370

350
kgs per capita

330

310

all grain (paddy rice) kgs/cap

all grain (paddy rice) + soy (kgs/cap)
290

270

250
1960 1965 1970 1975 1980 1985 1990 1995 2000

Source: FAO statistics; Colin Butler, personal communication, based on FAO data,
March 2004

Figure 4.3 Grain per person, world, 1961–2003

years later, neither the cod stocks nor the industry had re-
covered.16 Increasing numbers of environmental and agricultural
experts are warning about the pressures of similarly intensive
food production on natural resources.

REMARKABLE CHANGES IN AGRICULTURE AND

FOOD PRODUCTION
The challenge for the future of food supply is how to develop
sustainable production methods that take into account the health
of the oceans, rangelands and croplands of the planet. Professor
Marshall Martin, head of the Department of Agricultural Eco-
nomics at Purdue University in the US, identifies ‘environ-
mental quality’ as one of the key drivers of change,17 a second is
the industrialization of agriculture as farming continues to shift
from a rural lifestyle to an agribusiness sector with a supply-
138 FOOD WARS

chain mentality; and a third, according to Martin, will be firms

that can ‘link’ the food chain and added value in order to benefit
economically. An important aspect of these global dynamics is
the way in which global agricultural trade has advanced in recent
years. For example, today nearly one-third of US farm income is
derived from export sales when, only 35 years ago, the US was a
net importer of agricultural products. Land under soy produc-
tion in Brazil today is 26 million hectares, an increase from just
200,000 hectares 30 years ago.
It is generally agreed by analysts that one of the major
changes in world food demand will be in the demand for meat –
something the Washington DC-based International Food Policy
Research Institute (the IFPRI) has dubbed the ‘livestock revolu-
tion’.18 This will be driven by growing demand from developing
countries; however, an individual person in the developing
world in 2020 will still consume less than half the amount of
cereals and just over a third of the meat products consumed by a
person in the developed world. The IFPRI points out that people
in the developing world collectively consume almost half of the
global meat supply and by 2020 will consume two-thirds, as a
result of an almost 50 per cent increase in per capita consumption.
This presents a major production challenge. The IFPRI cautions:
‘The Livestock Revolution will stretch the capacity of existing
production and distribution systems and exacerbate environ-
mental and public health problems’.
This projected ‘livestock revolution’ for animal protein is
being fuelled by urbanization and population and income
growth in developing countries. By 2020 developing countries
will consume 100 million metric tons more meat and 223 million
metric tons more milk than they did in 1993, dwarfing developed-
country increases of 18 million metric tons for both milk and
meat; developing countries will be producing 60 per cent of the
world’s meat and 52 per cent of the world’s milk, led by China
for meat production and India for milk production.19 The revolu-
tion will also drive demand for increased cereal production for
use as animal feed especially in developing countries. In total,
global demand for cereals will increase by 39 per cent between
1995 and 2020 to 2466 million tons, and global demand for meat
will increase by 58 per cent to 313 million tons.
 THE FOOD WARS BUSINESS 139

UNDERSTANDING THE MODERN FOOD SYSTEM

Clearly these aggregate levels for cereals, meat (and for other
foodstuffs) make it possible to build a model for projected demand
and to start to weigh up the consequences of what growing so
much food over the past 50 years and into the next 15 years
means for farming and agriculture and for the processing
industries.
The 20th century witnessed arguably one of the most signi-
ficant food revolutions since settled agriculture began around
10,000 years ago. Although the roots of this revolution lay in
the 18th and 19th centuries, it was in the 20th century that the
application of chemical, transport, breeding and energy techno-
logies transformed food supply. Beginning in the UK and US
agricultural heartlands, radical changes to how food was grown,
processed, distributed, and consumed were experimented with,
applied and marketed. 20, 21 These countries entered the 20th
century already well endowed with processing technology, such
as the giant roller mills used in grain milling, and with industrial-
ized baking machinery enabling, for example, the production of
biscuits by the million. But these changes were nothing compared
to what was to follow. Giant machinery soon began to replace
human labour and ‘Fordist’ thinking was applied to both plant
and animal production.22 Large-scale experimentation was
expended on trying to reduce nature’s unpredictability.23
Agrichemicals replaced the hoe; feedlots replaced grazing;
monoculture replaced smallholdings. This growth owed much to
the spread of fossil fuel culture, in particular the use of oil to drive
machines.24
If the first half of the 20th century was marked by the
industrialization of both agriculture and processing, the second
half will surely be enshrined as the decades of retailing indus-
trialization.25, 26 New ways of packaging, distributing, selling,
trading and cooking food were developed, all to entice the
consumer to purchase. These power shifts in the food economy
have contributed to the contemporary conflict within the food
system between the ‘Productionist’ and ‘consumerist’ sectors:
agribusiness versus consumer business; primary producers
versus traders; food processors versus food retailers; and even
production interests versus public health goals. Other changes
140 FOOD WARS

saw year-round varieties of foods available from all corners of the

world and the virtual elimination in the seasonality of fruits and
vegetables by global sourcing.27, 28 However, when reduced to its
bare essentials, the global food economy is revealed as having a
relatively simple base: most consumers eat foods from a core
group of about 100 basic food items, which account for 75 per
cent of our total food intake.29
From this simple base a food economy of immense size and
economic power was created. Professor Marion Nestle notes that
of the $890 billion food and beverage sales in 1996 (total US food
and beverage sales were estimated at more than $1 trillion in
2002), nearly half was spent on items consumed outside the home
but only 20 per cent of food expenditures went to food producers;
the remaining 80 per cent constituted added value in the form of
labour, packaging, transportation, advertising and profits. In that
year, the US marketplace, featuring 240,000 packaged goods from
US manufacturers alone, saw 13,600 new food product intro-
ductions: 75 per cent of these were candies, condiments, breakfast
cereals, beverages, bakery products and dairy products. These
and other foods were advertised to the tune of $11 billion spent
on electronic and print media, with another $22 billion or so on
coupons, games, incentives, trade shows and discounts. In the
21st century, food and beverage product launches internationally
are occurring at the rate of more than 20,000 a year. 30 An
important consequence of such economic activity is that the
American food supply is providing 3800 kcal per day for every
man, woman and child in the country, an increase of 500 kcal per
day since 1970. This level is nearly twice the amount needed to
meet the energy requirements of most women, one-third more
than is needed by most men, and far higher than is needed by
babies and young children. Professor Nestle concluded: ‘These
figures alone describe a fiercely competitive but slow-growing
food marketplace, one in which food companies compete to sell
more of more profitable foods’.31
Thus, the 20th century saw a food supply chain revolution
characterized by integration, control systems and astonishing
leaps in productivity, as measured in labour and capital use. Its
more recent restructuring has seen key changes in:

l how food is grown, such as mass use of agrochemicals and

hybrid plant breeding;
 THE FOOD WARS BUSINESS 141

l how animals are reared: factory farms, intensive livestock

rearing, prophylactic use of pharmaceuticals to increase
weight gain;
l the emergence of biotechnology applied to plants, animals
and processing;
l food sourcing: a shift from local to regional and now global
supply points to monoculture;
l the means of processing, such as the use of extrusion techno-
logy, fermentation and cosmetic additives;
l the use of technology to shape quality and to deliver con-
sistency and regularity;
l the workforce: labour-shedding on developed world farms;
a retention of cheap labour and a strong push to 24-hour
work;
l marketing – a new emphasis on product development,
branding and selling;
l the retailers’ role as the main gateways to consumers;
l distribution logistics, such as the use of airfreight, regional
distribution systems, heavy lorry networks and satellite
tracking;
l the methods of supply chain management – centralization of
ordering and application of computer technology;
l the moulding of consumer tastes and markets – mass
marketing of brands, the use of product placement methods,
investments in advertising and marketing and the targeting
of particular consumer types;
l the level of control over markets – rapid regionalization and
moves towards globalization, and the emergence of cross-
border concentrations;
l the growing importance of tough, legally backed intellectual
property rights.

Table 4.1 plots some of these changes.

THE EMERGENCE OF FOOD COMPANY

CLUSTERS
Much discourse in food studies assumes the presence of a linked
‘food chain’. Figure 4.4 details a simple food and grocery chain,
142 FOOD WARS

Table 4.1 Directions of change in diet, food supply and culture

Issue Direction of change

Dietary change
(nutrition transition)
meat & animal products up
edible oils up
cereals down but variable
fruit and vegetables Varies
soft drinks up

Food supply
(concentration) farmers down
processors up
retail (supermarkets) up
eating out (‘fast food’) up
long-distance foods up
seasonal dependency down
import–export trade up
capital intensity up

Socio-cultural change
range of foodstuffs up (urban)
price relative to income down
packaging and appearance up
physical activity down
food inequality up

in this case for the UK, indicating how value is accrued along its
links and the sort of activities taking place.
At the end of the 20th century there was, amongst so many
other things, a rebirth of academic interest in food studies. One
rich seam which we can draw upon is known as agrarian political
economy – or a ‘food-systems’ – an approach pioneered by rural
sociologists trying to understand the deepening rural and farm
crisis and the squeeze on farming.32, 33 This approach tries to take
further the idea of the food supply chain or ‘value chains’ in order
to understand how and why different parts of that supply chain
have an impact on one another, 34 in the context of the rural
 THE FOOD WARS BUSINESS 143

Imports of
Imports of raw
raw materials
materials
Purchases from UK
Purchases from UK
and
and semi-processed
semi-processed
agriculture
Agriculture
products
products
£11
£11 bn
bn
£7 bn
£7 bn

Additional Costs
for example:
Additional costs Primary processing
Primary Processing
forLabour
example: for example:
for example:
Labour
Energy Milling
Energy Refining
Milling
Packaging Slaughtering/rendering
Packaging Refining
Plant and equipment Roasting/drying
Plant and Equipment Slaughtering/rendering
Utilities and
Utilities and services
Services Roasting/drying
Distribution
Distribution
Final stage-processing
Other(including
Other (including profit)
profit) Final Stage Processing

£47 bn
£47 bn Sales
Sales £65 bn
£65 bn

Food service Retail Of

Ofwhich
which
£35 bn
Foodservice £90 bn
Retail exports
Exports
£35 bn £90 bn £9£9bn
bn

Source: IGD data in UK Food and Drink Federation (2001) Submission to the Curry
Commission

*Note: The figures represent the monetary value of different stages as food passes
through the supply chain from farming to point of sale.

Figure 4.4 The UK food added-value chain, 2001*

economy. During the 1990s, social scientists interested in this

approach focused on four major areas:35, 36

1 how agrarian structures and state agricultural policies

developed over time in both the developed and developing
world and in the growth of globalized food regimes;
144 FOOD WARS

2 detailed empirical analyses of particular agricultural com-

modity regimes, with an emphasis on the structures and
strategies of multinational firms;
3 the role of regulation: how state practices and rules govern-
ing food systems are changing and how they shape agrifood
systems;
4 how key players and networks of interest work together to
formulate policy and define the workings of the food supply
chain.

Although these four areas have been identified as distinct areas

of theoretical and empirical study, in practice there are areas of
overlap. From our perspective a weakness of this work, as in
other areas of food studies, is that it too rarely acknowledges or
includes health as either an outcome of the food supply chain or
as a separate topic worthy of research and analysis.
Throughout the 1990s, a group of rural social scientists in the
US led by Professor Bill Heffernan developed an analysis of how
the food supply is being controlled and concentrated in the hands
of a few ‘food clusters’: that is, firms that control the food system
all the way from gene to supermarket shelf.37, 38 They suggested
that the changing nature of the food system means that relation-
ships between food corporations are becoming much more
complex and bound together. Acquisition is still the common
method of combining two or more firms, but mergers, joint
ventures, partnerships, contracts and less formalized relation-
ships such as agreements and side agreements are also used.
Professor Heffernan and his colleagues use the concept of
‘clusters of firms’ to represent these new economic arrangements
– predicting the development of five or six dominant food
clusters among US food companies, citing such links as between
Cargill and Monsanto, or ConAgra and subsidiary companies
along most parts of the food chain. This analysis reveals that
control in the food system is exercised by a handful of firms, and
US examples of Heffernan’s findings are given in Table 4.2.39
Just 20 feedlots feed half of the cattle in the US and these are
directly connected to the four processing firms that control 81 per
cent of the beef processing, either by direct ownership or through
formal contracts. In this sort of food system the farmer becomes
nearly a contractor, providing the labour and often some capital,
but never owning the product and never making the major
 THE FOOD WARS BUSINESS 145

Table 4.2 Concentration in the US food processing sectors40

Sector Concentration Companies involved

ratio
Beef packers 81% Tyson [IBP],
ConAgra Beef Cos
Cargill [Excel]
Farmland National Beef Pkg. Co

Pork packers 59% Smithfield, Tyson [IBP]

ConAgra [Swift]
Cargill [Excel]

Pork production 46% Smithfield Foods

Premium Standard Farms
[ContiGroup]
Seaboard Corp.
Triumph Pork Group [Farmland
Managed]

Broilers 50% Tyson Foods

Gold Kist
Pilgrim’s Pride
ConAgra

Turkeys 45% Hormel [Jennie-O Turkeys]

Butterball [ConAgra]
Cargill’s Turkeys
Pilgrim’s Pride

Animal feed plants 25% Land O’Lakes Farmland Feed

LLC/Purina Mills
Cargill Animal Nutrition
[Nutrena]
ADM [Moorman’s]
JD Heiskell & Co

Terminal grain 60% Cargill

handling facilities Cenex Harvest States
ADM
General Mills

Corn exports 81% Cargill-Continental Grain

ADM
Zen Noh
146 FOOD WARS

Table 4.2 (continued)

Sector Concentration Companies involved

ratio
Soybean exports 65% Cargill-Continental Grain
ADM
Zen Noh

Flour milling 61% ADM Milling

ConAgra
Cargill
General Mills

Soybean crushing 80% ADM

Cargill
Bunge
AGP

Ethanol production 49% ADM

Minnesota Corn Producers
[ADM has 50% equity stake]
Williams Energy Services
Cargill

Dairy processors n/a Dean Foods [Suiza Foods Corp.]

Kraft Foods [Philip Morris]
Dairy Farmers of America
Land O’Lakes

Food retailing 38% Kroger Co.

Albertson’s, Safeway
Wal-Mart
Ahold
Note: The percentage figure is the concentration ratio, relative to 100 per cent of the
top four firms in specific food industries

management decisions. The pricing mechanisms and hence

market so dear to traditional agricultural economists are all but
hidden; through contractual relationships the value is distributed
up the food chain and not at the farm level, as the production
stage is integrated into the larger food system. If, as another
example, 95 per cent of US broilers are produced under
production contracts with fewer than 40 firms, there is essentially
no price discovery for chicken feed, day-old chicks or live
 THE FOOD WARS BUSINESS 147

broilers; the food producer does not sell at these stages and the
price is not revealed until sold to the final consumer. Basically, in
the economic sense, there is no ‘free market’ for live broilers, just
one seamless supply chain. Professor Heffernan concludes:

Today, most rural economic development specialists discount agri-

culture as a contributor to rural development. The major reason why
agriculture contributes so little to the community is because of the
emerging structure of the food system.41

Food clusters give unprecedented power to a relatively small

number of companies, and it is difficult to establish dialogue with
vast corporations such as the US conglomerate ConAgra. In 1996
it accounted for 25 per cent of US sales in feed and fertilizer, 53
per cent of sales of refrigerated foods and 22 per cent of all
grocery products. Much food production in the developed world,
however, is still in the hands of smaller companies in a local or
regional context: food is still produced and consumed by rural
populations. It is estimated that 1.9 to 2.2 billion people are today
still excluded, directly or indirectly, from modern agriculture
technologies. In fact, only about one-fifth of the world’s 6 billion
people are able to participate in the cash or consumer credit
economy that modern food capitalism thrives on.42

FARMING BECOMING ‘IRRELEVANT’

One of the tragic consequences of the restructuring described
above is that the loss of farmers and family farms in the US and
Western Europe, for example, has little impact on transnational
corporations: corporations are often mainly concerned about
sourcing a product with the least cost and then move the product
where it can be sold for the highest price. In many poor countries,
workers in rural areas receive less than $5 a day, with health and
environmental regulations unlikely to be enforced, again helping
to drive down costs. It is remarkable how cheap labour character-
izes the supposed efficiencies of the food supply chain. Behind
low-cost food can be even lower cost labour.43 Transnational
corporations are experts at reaping the economic benefits of
globalization while pushing the economic, social and environ-
mental costs onto the public.44 In turn this makes developed
148 FOOD WARS

world farmers ‘high cost’ producers. Some neo-classical eco-

nomists now openly argue that consumers in the developed
world no longer need their own farmers because countries can
import food from poorer countries more cheaply. The solutions
offered by right-thinking analysts emphasize global market
efficiencies; this is why an estimated $35 billion is spent on
agricultural research annually.45 It is not clear that this money is
well spent. As in other areas of research, we would argue that
the approach of such farm economics has ideological framing
assumptions embedded within the science. Half a century ago,
economists were justifying and promoting a decentralized agri-
culture production and processing system, while today, much
economic theory defends a highly centralized monopolistic or
near-monopolistic system.46
Industrial farming or agribusiness – seeing fewer farmers, on
bigger tracts of land, producing a greater share of the total food
supply – is shaping food production into monocultures (some-
times referred to as ‘green concrete’): either the same crop is
grown year after year in the same field or very simple rotations
are used (such as corn–soybean–corn–soybean). The shift towards
monoculture and homogeneity in food production can only
happen with a technology ‘bundle’ consisting of mechanization,
the manipulation of crop varieties, the development of agro-
chemicals to fertilize crops and control weeds, insects and other
crop pests, as well as antibiotics and growth stimulants for
agriculture animals.47 Further up the production chain it means
the increasing fractionation of foodstuffs into smaller and smaller
biological components and ingredients and then the recombining
of these fractions into ‘value-added’ retail food products. Such
activity has spawned a massive food technology industry whose
practitioners have been increasingly involved over the past ten
years in ‘adding’ health ‘benefits’ to foods and beverages.
Food monoculture gives rise to the agricultural ‘treadmill’:
there is downward pressure on prices for farmers and upward
pressure on the inputs needed for production; farmers are forced
to adopt new technologies and increase their scale of production
or go out of business; over time, the geographical concentration
of production is into narrower and narrower locations or centres
of production.48 By 1994, 50 per cent of US farm products came
from 2 per cent of farms, while 9 per cent of produce came from
73 per cent of farms. For many food technologists, monoculture
 THE FOOD WARS BUSINESS 149

means battling to make retail food products cheaper to manu-

facture while maintaining their integral qualities.
This shift of the food dollar from farmers to other parts of the
food chain has gone hand in hand with intense concentration at
every other link in the food chain – from farm inputs (such as
fertilizers and pesticides) to food processing and retailing. In the
US, the share of the consumer’s food dollar that gets back to the
farmer has dropped from around 40 cents in 1910 to 7 cents in
1997; in the UK, the same has occurred and the gap between
farmers’ prices and the retail prices has become a very conten-
tious issue. In July 2002, for example, supermarkets were accused
by the UK National Farmers’ Union of overcharging consumers
for milk but underpaying dairy farmers: the price paid to farmers
for milk had fallen over the previous year from 20 to about
14 pence a litre, while consumer prices had remained constant
at around 45p.49 The fall in the monies received by US farmers
was graphically illustrated in March 2000 at a farm rally in
Washington DC when farmers served legislators a ‘farmers
lunch’. Typically an $8 lunch – of barbecued beef on a bun, baked
beans, potato salad, coleslaw, milk and a cookie – they charged
only 39 cents, reflecting what farmers and ranchers actually
received to grow the food for such a meal.50
The economic pressures of the treadmill have led to a sharp
decline in the numbers of so-called ‘inefficient’ farms, with
smaller family farms being particularly badly hit. For example,
in the US there were close to seven million farms in the 1930s, but
less than 1.8 by the mid-1990s; in France 3 million farms in the
1960s, yet fewer than 700,000 in the 1990s; 450,000 farms in the
UK in the 1950s, half that number in the 1990s. Over the past 50
years the number of actual farmers has declined by 86 per cent
in Germany, 85 per cent in France, 85 per cent in Japan, 64 per cent
in the US, 59 per cent in Korea and 59 per cent in the UK.51
For economists these long-term trends represent greater
efficiencies from economies of scale. From this perspective,
however, the remaining number of large farms still remains high,
especially in comparison with concentration in other industrial
sectors, and many economists predict a continuing reduction
in farm numbers, as though this is natural and desirable.52 While
the number of farms remains stubbornly high, in many global
primary commodity markets there already is considerable con-
centration and control of markets: five corporations, for example,
150 FOOD WARS

market 60–90 per cent of all wheat, maize and rice; three corpora-
tions control 80 per cent of banana trade; three corporations
control 83 per cent of cocoa trade; three corporations control 85
per cent of tea trade.53 It is a similar story with agrochemicals: in
the late 1980s, the top 20 firms worldwide accounted for around
90 per cent of sales; by the late 1990s, ten firms controlled this
much of the market; in 2003, it was just seven.54
To use Canada in more detail, while in 2000 there were
276,548 farms supporting the Canadian food chain (down from
430,522 in 1966), today:

l three companies retail and distribute gasoline and diesel fuel;

l three produce most nitrogen fertilizer;
l nine make pesticides;
l four control the seed market;
l three produce most of the major farm machinery;
l nine grain companies collect all Canadian grain;
l two railways haul it;
l four companies dominate beef packing;
l four companies mill 80 per cent of Canadian flour; and
l five control food retailing in Canada.55

In a 2003 study the Canadian National Farmers Union (CNFU)

argued that, over the 14-year period since the signing of the 1989
Canada–US free trade agreement (CUFTA) (and the implementa-
tion of the North American Free Trade Agreement in 1994 and the
World Trade Organization Agreement on Agriculture in 1995)
‘free trade’ is simply not working: while Canadian farmers have
more than doubled exports with agrifood exports growing from
CAN$10.9 billion in 1988 to CAN$28.3 billion in 2002, Canada is
facing its worse farm income crisis since the 1930s: ‘Free trade
agreements may increase trade but, much more importantly,
they dramatically alter the relative size and market power of
the players in the agri-food production chain . . . much more
significant . . . may be the effect these agreements have on the
balance of market power between the farmers and agribusiness
corporations.’56
But even the economics of the remaining farms is distorted
towards the largest. In the US, the 122,000 largest farms,
representing only 6 per cent of the total number, receive close to
60 per cent of total farm receipts. These large farms have also
 THE FOOD WARS BUSINESS 151

been able to reap a disproportionate amount of government

support payments, receiving over 30 per cent of the payments for
commodity programmes. In 2002 President Bush announced a
$180 billion support package for farming, while in the EU the
financial strain of the $40 billion Common Agriculture Policy is
prompting calls for radical reform. Although calculations of farm
subsidy figures need to be treated with caution, it has been
estimated that in 1998 agricultural subsidies in OECD countries
totalled $362 billion – 2.5 times the combined gross domestic
product of all the world’s least developed countries.57

A NEW ‘HEALTH’ COLONIALISM?

A more recent feature of agricultural trade has been the devel-
opment of new food commodity chains, especially for fresh
produce, built upon production in developing countries for
consumption in rich countries. This trend is giving rise to a
different form of competition not only between ‘logistic’ chains
such as bananas and exotic fruits, but also whole food production
systems. Table 4.3 illustrates the banana logistics chain for a
Caribbean producer and a UK supermarket, showing product
flow from field to store. Bananas were in 2003 a significant
contributor to UK supermarket profits, suggesting health and
high turnover at the point of consumption; the sad reality is that

Table 4.3 The banana supply chain60

Stage in product flow Time taken

Field to leaving the packhouse 3 hours
Packhouse to loading in the ship 11 hours (maximum)
Shipment to Zeebrugge 13 days
Transport to storage in Kent, UK 12 hours
Storage in Kent, UK 5–6 days
Delivery and store in supermarket depot 12 hours (maximum)
Delivery to store 1–2 hours
Maximum shelf life in store 2 days
152 FOOD WARS

most banana workers in Ecuador earn wages that are below half
of what is required to feed an average family. Of every £1 retail
price for Ecuadorian bananas, the plantation worker receives just
1.5 pence, whereas the plantation owner receives 10 pence, the
trading company 31 pence (of which the EU tariff is 5 pence), the
ripener/distributor 17 pence, and the final retailer 40 pence.58 For
a 40lb box of Costa Rican bananas sold in the UK supermarket
for the equivalent of £14.69, the grower would have received a
maximum of £2.22, only 15 per cent of the resale value.59
The banana story is but one part of what has been described
as a disaster for small farmers who trade in tropical commodities
such as coffee, cocoa, rubber and sugar where the price per tonne
in US dollars is lower today than it was in the early 1980s.61 This
hard analysis presents a challenge to the conventional liberal
argument that world trade rules need to be redesigned to allow
‘fair ’ prices for such goods. The new analysis suggests that
encouraging developing countries to pour out such commodities
creates over-production and is not the panacea for the ills of
economic development.
Horticultural exports from developing countries have also
become a major growth sector in international trade, driven by
supermarket policy to offer consumers year-round supplies
of fresh produce sourced from different areas of the world. A
team led by Dr Hazel Barrett and Professor Brian Ilbery has
documented the horticultural trade for Kenya where 85 per cent
of the country’s horticultural trade is destined for just four EU
countries: the UK, The Netherlands, France and Germany. Most
of this business is through supermarkets. By the mid-1990s
horticultural exports accounted for 10 per cent of total Kenyan
export earnings (and are the third most important agricultural
export after tea and coffee),62 supplying green beans, mange-tout,
runner beans, okra, chillies, aubergines, avocados, mangoes and
cut flowers to Europe, 93 per cent of which is delivered by air.
Barrett and her colleagues have documented how, to meet the
growing demand for consignments of produce to EU super-
markets, Kenyan export production concentrated in the hands of
the larger and highly capitalized producers. There are now signs
that China could enter this export trade. Historically associated
with intensifying its agriculture to keep pace with a burgeoning
population, China’s food policy is poised to reposition itself
as a potential exporter of labour-intensive foods; it has low
 THE FOOD WARS BUSINESS 153

production costs, amenable to some intensive but high-value

exports. One estimate of onion production, for instance, found
that China had costs of US$3605 per hectare, compared with
onion growing costs of $5110 in the US and $20,901 in Japan.63
The mechanics of the Productionist paradigm have altered,
both figuratively and literally, the landscape and practice of
farming and agribusiness. As Productionist-style agriculture
struggled to find acceptable levels of profitability, it turned
increasingly to global trade liberalization as one route out. But
as the limits of chemical farming technologies are reached, the
new business model is aiming to capture value throughout the
food chains, starting with the seeds to grow food, and to impose
a new homogeneity on agricultural production. Control is the
crux of the Life Sciences Integrated paradigm. The Ecologically
Integrated paradigm, however, aims for different kinds of effici-
encies through reducing inputs, and re-aligning of production
and land to smaller-scale, biodiverse and localized farming
practices.

THE GLOBAL SCOPE AND ACTIVITY OF FOOD

PROCESSORS
In food manufacturing, as well as in agriculture, big business is
getting bigger, despite small-scale food companies continuing to
survive through ‘niche’ and specialty markets. The world’s top
three food processing companies at the turn of the millennium
were Nestlé with global food sales of US$44,640 million, Philip
Morris (Kraft) topping $26,532 million and ConAgra Foods Inc
with sales of $25,535 million, giving combined global food sales
for these three alone of a huge $97 billion. Table 4.4 lists the
world’s 50 largest food groups based on food sales. It is important
to recognize that, compared to other industrial sectors such as
aerospace or the automotive industries, food manufacturing is
not nearly as concentrated; the food industry remains highly
fragmented.
Another survey, this time of the world’s leading 50 grocery
manufacturers, found that only four food companies were big
enough to make it into the Fortune Global 100, a US business
index of the biggest corporations in the world. The same survey
154 FOOD WARS

Table 4.4 World’s top 50 food groups, 200064

Total sales Food sales
Rank Company $ millions $ millions
1 Nestlé 47,489 44,640
2 Philip Morris Co Inc 80,356 26,532
3 ConAgra Foods Inc 25,535 25,535
4 Cargill 47,602 22,500
5 Unilever Bestfoods 41,403 20,712
6 The Coca-Cola Company 20,458 20,458
7 PepsiCo Inc 20,438 20,438
8 Archer Daniels Midland Company 20,051 20,051
9 IBP Inc 16,950 16,950
10 Arla Foods 15,824 15,824
11 Diageo 16,938 15,584
12 Mars 15,300 15,300
13 Anheuser-Busch 12,262 12,262
14 Danone 12,576 12,123
15 Kirin Brewery Co 12,826 11,928
16 HJ Heinz Company 9430 9430
17 Asahi Breweries 11,351 9194
18 Suntory 10,485 8823
19 Snow Brand Milk Products 9256 8516
20 Sara Lee Corporation 17,511 7705
21 Dairy Farmers of America 7600 7600
22 Nippon Meat Packers 7389 7389
23 Tate & Lyle 8058 7252
24 Tyson Foods 7158 7158
25 General Mills Inc 7078 7078
26 Kellogg Company 6955 6955
27 Interbrew 7038 6898
28 Cadbury Schweppes 6515 6515
29 Parmalat 6466 6466
30 Maruha 7232 6292
31 Campbell Soup Company 6267 6267
32 Eridania Beghin-Say 8625 6038
33 Smithfield Foods Inc 5900 5900
34 Heineken 6175 5891
35 Associated British Foods 6289 5660
36 McCain Foods Ltd 5603 5603
37 Yamazaki Banking 5919 5504
38 Suiza Foods Corporation 5756 5410
39 Ajinomoto 7372 5308
40 The Quaker Oats Company 5041 5041
41 Meiji Mild Products 5748 4943
42 Dole Food Company Inc 4763 4763
43 Cenex Harvest States Co-operatives 8571 4714
44 Procter & Gamble 39951 4634
45 Lactalis 4609 4609
46 Novartis 20,879 4593
47 Tchibo 8819 4410
48 Danish Crown 4318 4318
49 Uniq 4249 4249
50 Hershey Foods Corporation 4221 4221
 THE FOOD WARS BUSINESS 155

found that the global top 50 grocery companies also accounted

for less than a quarter of the consumer expenditure on food, drink
and tobacco in the developed world – although just 20 of the 50
accounted for 69 per cent of combined turnover.65 So even within
the 50 largest players, there is considerable concentration and
differentiation.
The food industry is the leading industrial sector in the
European Union (with 15 Member States), with production
estimated at €572 billion accounting for 13 per cent of the total
EU manufacturing sector.66 It is the EU’s third-largest industrial
employer with over 2.5 million employees, or 11 per cent of
employment. Although dominated by a relatively small number
of giant food firms, the food sector is characterized by a relatively
low concentration. In 2000, 99.3 per cent of all food and drink
companies were defined as small- and medium-sized enter-
prises, or SMEs (that is, less than 250 employees). Of the EU’s
257,807 food and beverage companies, SMEs account for one half
of total EU production and 62 per cent of employees. Large food
companies – just 0.7 per cent of all EU companies – produce half
of all EU’s production. It is a diverse industry, reaching across a
wide range of production, covering both first-stage processing
(agricultural produce) as well as second-stage processing (fabric-
ated products). It is also displays relatively stable overall growth
of around 2 per cent a year, albeit with significant variations
between the various branches that make up the food and drink
industry. Four sectors dominate the EU food industry: beverages,
‘various products’ (which includes bakery, chocolate and
confectionary products), meat products and dairy products (by
production 16, 27, 20 and 15 per cent, respectively; by added
value 19, 37, 17 and 10 per cent, respectively). France, Germany,
Italy, the UK and Spain are the leading producers of foods,
representing 80 per cent of total EU production (when 15
Member States).

LONG-TERM STRUCTURAL CHANGE IN FOOD

MANUFACTURING AND PROCESSING
In 1981, the OECD identified in a seminal study of the food
industry a range of pressures on resources employed in the food
economy and outlined the choices facing the food industry:67
156 FOOD WARS

l improving efficiency (lowering unit costs);

l diversification of product ranges and costs;
l remaining within the food economy, but accepting lower
returns on resources;
l transferring resources to activities providing higher returns;
l persuading governments to subsidize the various parts of the
food economy.

These OECD ‘predictions’ have proved remarkably prescient. In

our view, the key components of business strategy led by food
manufacturers today now include:

l restructuring and concentration through factory closures;

l cost savings through massive reduction in numbers of
employees;
l increasing scale of production in the remaining factories;
l mergers and acquisitions and other intra-firm alliances;
l focusing on core brands;
l focusing on key product categories.

Food manufacturing locks companies into a never-ending stream

of new product introductions – the vast majority of which fail.68
For example, annual new food and beverage product launches
between 1994 and 2000 in North America averaged 14,358 per
annum over the seven-year period: that is 100,506 products over
seven years.69 Food companies strive to introduce products with
health benefits in order to differentiate their product from others
within this flood of product launch activity; product differentia-
tion strategy is not always supported by science and products too
often go under.
For many branded food manufacturers there has recently
been renewed focus on brand value. Even the leading consumer-
brand companies, often as a result of their histories, are still
wedded to a Productionist and ‘economy of scale’ business
model: selling masses of commodity-style products and food-
stuffs to keep factories churning at near maximum capacity,
which maintains ‘production-led’ rather than ‘consumer-led’
marketing. Brands and brand marketing remain one of the central
pillars for the future of food companies.
 THE FOOD WARS BUSINESS 157

CHANGING COMPANY CULTURES FOR THE

21ST CENTURY
In the modern economy food manufacturers are something of an
anachronism: ‘big business’ but not very exciting to stockbrokers;
they are not just ‘old economy’, but positively ‘ancient economy’
in terms of the history of capitalism. A brief history of Nestlé
(Box 4.1), founded in 1866, illustrates the long-lasting and con-
servative nature of the food industry:

BOX 4.1 A BRIEF HISTORY OF NESTLÉ70

1866 Company founded
1905 Merger between Nestlé and Anglo-Swiss Condensed Milk
Company
1929 Merger with Peter-Cailler-Kohler Chocolats Suisses SA
1947 Merger with Alimentana SA (Maggi)
1971 Merger with Ursina–Franck (Switzerland)
1985 Acquisition of Carnation (US)
1988 Acquisition of Buitoni–Perugina (Italy)
1988 Acquisition of Rowntree (GB)
1992 Acquisition of Perrier (France)
1995 Acquisition of Victor Schmidt & Söhne, Austria’s oldest
producer of confectionery
1997 Through the Perrier Vittel Group, expands its mineral water
activities with the outright acquisition of San Pellegrino
1998 Acquisition of Spillers Petfoods of the UK and the Carnation
Friskies brand

To achieve its near $50 billion of annual sales, Nestlé products at

the start of the 21st century included:

l soluble coffee
l roast and ground coffee
l water
l other beverages
l dairy products
158 FOOD WARS

l breakfast cereals
l infant foods
l performance nutrition
l clinical nutrition
l culinary products
l frozen foods
l ice cream
l refrigerated products
l chocolate and confectionery
l food services and professional products
l pet care
l flavours for the food industry
l pharmaceutical products.

With such diversity, it seems incredible that even a giant of

the global food stage should have to re-invent itself for the
new century as we saw at the end of Chapter 3. The Coca-Cola
Company, too, dates back to the 19th century, its product being
founded in 1886 as a health food drink (initially a hangover
cure);71 it has grown to become one of the world’s leading manu-
facturers, and has operations in 200 countries, yet is not immune
from the new tensions in modern food supply. With revenues of
US$20,458 million in 2000, the company embarked on a major
restructuring process that included reducing its workforce by a
fifth (that is, by 6000 jobs) and recuperating from a multi-million
dollar product recall in 1999. Worse, Wall Street in 2000 was
marking the company’s stock down heavily from the glory days
of the 1980s and early 1990s. Its competitors were also being seen
as a lot more viable in the carbonated soft drinks market as
consumers thirsted for drink alternatives.72, 73 The company was
facing a strategic impasse and, worst of all for a consumer brands
company, was seen as out of touch.

FROM GLOBALIZATION TO LOCALIZATION

Coca-Cola’s strategy for recovery was to go for a new scheme
it called ‘localization’: defined by Douglas Daft, Coca-Cola’s
then CEO, as a promise to ‘think locally, and . . . act locally . . .
making sure we are operating as a model citizen . . . so those two
 THE FOOD WARS BUSINESS 159

principles – brands, and citizenship – are key to our business’. He

highlighted people and new opportunities as the key to new
success, and claimed that, ‘instead of seeing an admirable stock-
price as the ultimate driver of our actions . . . we must see admir-
able actions as the ultimate driver of our stock price’.74
Many other major food processors are rethinking their busi-
ness strategy along similar lines. A change in company approach
and culture is being addressed by Unilever, with worldwide sales
of £47.5 billion in 2000 and a diverse portfolio of products rang-
ing from soap powders to foods. Unilever’s new ‘Pathway to
Growth’ strategy resolved to concentrate product innovation and
brand development on just 400 brands, down from around 1200
in its original portfolio; to revise knowledge and information
systems; and to reorganize or sell off under-performing busi-
nesses.75 Unilever estimated this restructuring strategy would
reduce its workforce of 295,000 in 2000 by £3.3 billion in total and
lead to a reduction of 25,000 jobs worldwide over a five-year
period. The objective is to achieve £1 billion annualized savings
by 2004, to increase annual growth to 5 per cent and operating
margins to 15 per cent.
Coca-Cola and Unilever are particularly visible and articulate
expressions of thinking about change in response to health and
social demands, and about restoring their intangible assets of
brands and trust: that is, their intellectual capital, not just pro-
duction efficiencies alone. The future for food, according to these
giant companies, lies in a composite strategy that includes:
implementing knowledge management; exploiting imagery and
brands more successfully; clarifying the emotional appeal of
products; how a company is perceived or trusted by consumers;
and as Douglas Daft of Coca-Cola put it, through reconnecting
with the ‘local’. Biotechnology might open up new opportunities
but, above all, health is central to this composite approach.
Thus, the world’s major food manufacturers are redefining
their vision, mission, values and strategic focus for the future.
They will need to wrestle with the implications of the competing
frameworks we define as the Productionist, Life Sciences Integ-
rated and Ecologically Integrated paradigms. The redefining of
food manufacturers is in part a response to the changes they see
ahead in food retailing and food service over the next five to ten
years.
160 FOOD WARS

RAPID CONSOLIDATION AND CONCENTRATION

IN FOOD RETAILING

Part of the rationale for this major rethink by branded food

manufacturers is the need for a competitive response to the
power of international food retailers. It is predicted that just a
handful of – perhaps six – food retailers will dominate global
food sales in the next few years.
The power of the food retailer is illustrated by the US corpora-
tion Wal-Mart – America’s most ‘admired’ company of 2003,
according to Fortune magazine.76 With total annual retail sales of
US$250 billion, it operates 4300 stores in nine countries. Within
ten years of entering the food trade it drove down market prices
by 13 per cent. The impact on food producers has been immense:
in the US, 10 per cent of Kraft sales now go through Wal-Mart
(17 per cent of Procter & Gamble’s annual revenue), and some
analysts suggest that the success of Wal-Mart has influenced food
industry mergers such as Kellogg’s purchase of Keebler in 2001,
and the merger of Kraft and Nabisco in 2000.77
By 2010, the top seven US retailers are forecast to control close
to 70 per cent of the food retailing environment, with Wal-Mart
driving its grocery share to a massive 22 per cent. Similar con-
centration pressures are occurring in European markets, as
Figure 4.5 shows. The growth in market share being anticipated
for the top ten European grocery retailers to 2010 is expected to
increase from 37 per cent to 60 per cent in just one decade. Their
combined European grocery turnover will grow from €337 billion
in 2000 to €462 billion by 2005 and €670 billion by 2010. Table 4.5
identifies the world’s leading food retailers in 2002, and Table 4.6
identifies Europe’s top food retailing companies in 2001.
Dr Bill Vorley in a 2003 report for Development NGOs –
anxious about the squeeze on primary producers of commodities
– has suggested that the European market also exhibits ‘bottle-
necks’ where a tiny number of powerful firms can control the
dynamics of the supply and value chain.80 The European retailing
market illustrates this perfectly. A report in the same year by CAP
Gemini estimated that the EU 2002 retail market prior to EU
enlargement comprised:81

l consumers and customers: 249 million

l outlets: 170,000
 THE FOOD WARS BUSINESS 161

Table 4.5 Leading global food retailers, 200278

Rank Company Country Turnover No. of % Foreign Ownership
(million $) countries sales
1 Wal-Mart US 180,787 10 17 Public
2 Carrefour Fr 59,690 26 48 Public
3 Kroger US 49,000 1 0 Public
4 Metro Ger 42,733 22 42 Public/
family
5 Ahold Nl 41,251 23 83 Public
6 Albertson’s US 36,762 1 0 Public
7 Rewe Ger 34,685 10 19 Co-operative
8 Ito Yokado (incl
Seven Eleven) Jap 32,713 19 33 Public
9 Safeway Inc US 31,977 3 11 Public
10 Tesco UK 31,812 9 13 Public
11 Costco US 31,621 7 19 Public
12 ITM (incl Spar) Fr 30,685 9 36 Co-operative
13 Aldi Ger 28,796 11 37 Private
14 Edeka (incl AVA) Ger 28,775 7 2 Co-operative
15 Sainsbury UK 25,683 2 16 Public/
family
16 Tengelmann
(incl A&P) Ger 25,148 12 49 Private/
family
17 Auchan Fr 21,642 14 39 Private/
family
18 Leclerc Fr 21,468 5 3 Co-operative
19 Daiei Jap 18,373 1 0 Public
20 Casino Fr 17,238 11 24 Public
21 Delhaize Bel 16,784 11 84 Public
22 Lidl & Schwartz Ger 16,092 13 25 Private
23 AEON (formerly
Jusco) Jap 15,060 8 11 Public
24 Publix US 14,575 1 0 Private
25 Coles Myer Aus 14,061 2 1 Public
26 Winn Dixie US 13,698 1 0 Public
27 Loblaws Can 13,548 1 0 Public
28 Safeway plc UK 12,357 2 3 Public
29 Lawson Jap 11,831 2 1 Public
30 Marks & Spencer UK 11,692 22 18 Public
Total 930,537
162 FOOD WARS

Table 4.6 Europe’s leading retailers, 200179

Retailer Rank Rank European total European

(ERI)* (Turnover) grocery market status
share
Carrefour 1 1 7.2% Leading
pan-European
Metro 2 2 1.9% Leading
pan-European
Auchan 3 5 2.9% Major
Aldi 4 7 2.9% Major
Lidl & Schwarz 5 14 1.7% Major
Ahold 6 10 2.4% Major
Tesco 7 6 3.3% Major
Rewe 8 4 2.3% Major
ITM 9 3 2.9% Major
Casino 10 15 1.7% Major
Tengelmann 11 12 1.3% Major
Wal-Mart 12 13 1.9% Major
Total 32.4%
Note: ERI is IGD’s composite index measuring both ‘hard’ factors such as turnover,
and ‘soft’ factors such as culture, strategy and internal learning

Larg est 2n d Largest 3rd Largest N ext 7 L argest

80 0

70 0 60.5%

60 0

50 0 45.9%
3 8 7 .8
billions

40 0 37.4%

2 6 0 .9
30 0
1 8 9 .4 7 2 .7
20 0
4 8 .5 7 8 .0
3 1 .9 5 8 .7
10 0 4 8 .9
1 3 1 .1
6 6 .9 9 3 .7
0
20 00 20 05 20 10
Source: IDG Research, 2001

Figure 4.5 Anticipated growth of concentration in European food

retailing (by sales), 2000–2010
 THE FOOD WARS BUSINESS 163

l supermarket formats: 600

l buying desks: 110
l manufacturers: 8,600
l semi-manufacturers: 80,000
l suppliers: 160,000
l farmers/producers: 3.2 million.

The power of the 110 buying desks will shrink with concentration
and cross-border mergers. The eventual impact on consumers
will depend significantly on the nature of the competition
between the large retail chains and on whether buying groups (of
large retailers) allow small retailers to compete. 82 In the US,
‘horizontal integration’ – retailers buying each other out – has
been an increasingly common strategy.
Supermarket power and the trend to ‘hypermarketization’
are not just limited to rich, developed countries. Recent studies
by Professor Tom Reardon and colleagues have shown the re-
markable rise of supermarket power in developing regions such
as Africa, Latin America and Asia.83 In Latin America, where four
in ten people live in poverty, the supermarket share of food retail
markets rose from 10 to 20 per cent in 1990 to 50 to 60 per cent by
2000.84 In China, following a change of state policy in 1992 to
favour supermarket development and privatization, there has
been very fast emergence; by 1994, 150 chains owning 2500 stores;
by 2000, this had grown to 2100 chains with 32,000 stores.85 The
supermarket share of urban Chinese food markets was 48 per
cent in 2001, up from 30 per cent two years earlier in 1999.86
Although much ‘supermarketization’ is supported by ‘national/
home’ finance, foreign joint venture activity accelerated remark-
ably from the 1990s. Companies such as Carrefour of France (the
world’s second largest food retailer after Wal-Mart) achieved
37 per cent foreign sales out of its 1999 total sales. In the same
year, Wal-Mart had just 13 per cent foreign sales, The Netherlands-
based Ahold had 76 per cent and Tesco in the UK was rapidly
building on its 10 per cent foreign sales. With home markets
saturated, joint ventures with foreign chains (perhaps leading to
ultimate takeovers) is perceived as making good financial and
marketing sense. Foreign direct investment has overwhelmingly
come from the three giants of global finance capital (the US, the
EU and Japan)87 but other regions are generating their own
powerful retail forces. In South Africa, for example, 1700 stores
164 FOOD WARS

provide 55 per cent of food sales for 35 million people, and its
leading supermarket chains such as Shop Rite have crossed
borders and become regional powers. Although concentration
and supermarket penetration is advanced in some countries, the
picture is not universal. Nigerian supermarkets have only 5 per
cent market share; Bolivia has a low supermarket rate while
Brazil’s is high; India has few supermarkets compared to Korea.
Such differences may occur because supermarkets are tradition-
ally associated with packaged rather than fresh foods which in
developing countries at least still tend to be sold in markets or
street stalls or specialist stores and to be central to food culture.
But food retailers do not make their money solely from selling
foods and beverages to the consumer. To win market share and
to control the flow of foodstuffs to the consumer, retailers charge
manufacturers fees for ‘slotting’ (paying for a product ‘slot’ on
the shelf), display and presentation, and pay-to-stay and failure
fees. It has been estimated that the large US retailers generate
some $9 billion through such methods. 88 These retailer fees
present barriers to smaller processors and farmers, and also to
consumers and communities. Because inner urban and rural
areas are no longer profitable for global food clusters, they get left
behind in retail developments; in addition, consumer choice, in
the sense of where and what to buy, becomes more restricted.
French-based retailer Carrefour, after its merger with Promodés
in 1999, became overnight the biggest retailer in France, Spain,
Belgium, Portugal, Greece, Brazil, Argentina, Taiwan and
Indonesia, with stores in 26 countries.89
The world business future for food retailing is that there will
be local companies or global companies and not much in between.
Three forces are pushing the top retailers to further globalization:
first the growing sophistication of consumers,90 second, capital
intensification to extract ever-tighter financial returns; and third,
the need to get the best price from suppliers in order to stay
competitive, globally sourcing while appearing local.

FOOD RETAILERS AND THEIR SUPPLIERS

Prior to the EU growing from 15 to 25 countries in 2004, the
combined populations of Britain and Germany accounted for
40 per cent of the EU. With more than 208,000 stores, the two
 THE FOOD WARS BUSINESS 165

countries owned 30 per cent of supermarkets, a market share of

44 per cent of total EU-15 grocery sales. That is why Wal-Mart
decided to establish its first European base camps in both Britain
and Germany.
The UK is dominated by four large food retailing companies
– Tesco, Sainsbury, ASDA and Safeway – which account for 47.3
per cent of spending in the sector. Since the entry of Wal-Mart into
the UK with its acquisition of ASDA, price competition has
become a key characteristic of UK food retailing. But a rare
insight, before Wal-Mart’s influence in the UK, into the inner
workings of retail domination of the food economy was revealed
by the UK government’s 2000 Competition Commission inquiry91
which identified 24 supermarkets which fell within its terms of
reference. Five of these had 8 per cent or more of the market each:
Tesco (24.6 per cent), Sainsbury (20.7 per cent), ASDA/Wal-Mart
(13.4 per cent), Safeway (12.5 per cent) and Somerfield (8.5 per
cent).92 The Commission questioned whether price trends in the
UK compared with abroad and recent falls in wholesale prices,
especially in the livestock sector, were being fully reflected in
prices charged to consumers. The Commission identified 27
practices by supermarkets that were against the public interest
and recommended that a code of practice between retailers and
suppliers be implemented. These business practices, the Com-
mission said, gave the UK’s five major supermarkets substantial
advantages over other, smaller retailers whose competitiveness
was likely to suffer as a result. The Commission found the major
supermarkets operated ‘against the public interest’ but they
could find no market remedy for this other than to suggest that a
voluntary ‘code of practice’ be developed by the retailers to guide
their dealings with their suppliers. The Commission found that
the UK’s major supermarkets engage in a number of business
practices against the public interest that distort competition, but
still said the industry is ‘securing a good deal’ for the British
consumer.
The Commission also uncovered regular selling, by all the
five main retailers, of some frequently purchased products below
cost: the so-called Known Value Items (KVIs). ‘Price flexing’ (that
is the way supermarkets sell the same product, but at different
prices depending on the location in the UK) was found to be
practised by Safeway, Sainsbury and Tesco, thus distorting com-
petition in the supply of groceries.
166 FOOD WARS

The Competition Commission report detailed the extra-

ordinary relationship between supermarkets and their suppliers:
a one-sided business relationship in favour of the supermarkets
that has created a climate of fear to such an extent that the
Commission found it hard to communicate with suppliers. They
feared being de-listed and the weakening of the terms or values
of orders. Indeed, the Commission found very low margins
among suppliers to supermarkets, noting the 1999 average oper-
ating margin as 4.3 per cent, with many as low as 2 per cent, and
some. The Commission’s examination of trading found even
negative margins.
Another interesting finding was on product promotions.
Promotional activity in supermarkets is considerable. Sainsbury,
for example, offered promotions over the course of a year on
10,000 items out of its 20,000 main product lines; but one of the
effects of this culture of constant promotions is that it makes it
very difficult for consumers to work out comparative or com-
petitive prices, and it constitutes ‘a lack of full transparency’.
Other negative business practices pursued by the super-
markets include:

l over-ordering goods at a promotional price from a supplier

which are then sold into retail at a higher price without
compensating the supplier;
l requesting compensation from a supplier when the multiple’s
profit on a product is less than it expects;
l seeking discounts from suppliers retrospectively which
reduce the price of the product agreed at the time of sale;
l requiring suppliers to purchase goods or services from desig-
nated companies, such as hauliers and labelling companies,

Table 4.7 UK food retail market share (%), 1900–200093

Independents Multiples Co-ops

1900 80 5 15
1960 60 20 20
1970 44 37 19
1980 25 57 18
1990 10 76 14
2000 6 88 6
 THE FOOD WARS BUSINESS 167

from whom the supermarkets often also received a com-

mission.

Through global expansion and consolidation, food retailers are

looking to wrest even greater control over pricing and pro-
motions away from food manufacturers. For the foreseeable
future, food retailers that grew strong within the framework of
the Productionist paradigm and helped shape its workings, will
be the key to its future. They will also be key whether the Life
Sciences Integrated or Ecologically Integrated paradigms have
any future. They will determine the conditions under which
health is delivered or swamped by unhealthy arguments. Their
power is immense over the health of food supply as well as over
their suppliers. When the major UK retailers decided, for example,
not to stock GM products, reacting to consumer concern, this
effectively blocked the European market and, similarly, their late
embrace of organic produce has stimulated rapid market growth,
albeit from very low levels. And in 2003, the Competition Com-
mission, asked to adjudicate on whether a proposed takeover of
Safeway, the fourth largest chain, by Morrison’s a smaller but
highly capitalized and profitable chain was against the consumer
interest, gave the takeover the go-ahead, effectively triggering
yet another round of consolidation.94

THE SCALE OF THE FOOD SERVICE

INDUSTRIES
Even more poorly acknowledged in food policy until recently
than the role of food manufacturing are the food service indus-
tries, partly due to their fragmented nature, ranging as they do
from ‘greasy’ roadside cafés to up-market restaurants, and from
schools to the workplace. But the totality of food manufacturing
and processing and food retailing needs to be seen within the
context of the remarkable growth in food service and catering
over the past 30 years. Up to half of consumer expenditure on
food and drink in developed countries is now spent outside the
home, and the global market for consumer food service is forecast
to be worth around $1.6 trillion by 2004 (see Tables 4.8 and 4.9).95
In the US, the 89 publicly traded US restaurant companies had
Table 4.8 World food service – outlets by region, 1995–200096

% growth
Region 1995 1996 1997 1998 1999 2000 1995/2000
Asia–Pacific 3,547,430 3,755,754 3,970,980 4,196,713 4,399,359 4,594,772 30

Latin America 1,182,852 1,235,240 1,253,937 1,272,202 1,289,165 1,307,439 11

Western Europe 1,088,546 1,109,939 1,140,642 1,163,172 1,182,989 1,201,801 10

Africa and the Middle East 360,906 408,085 454,878 495,472 583,337 592,905 64

North America 384,758 395,729 406,065 416,055 426,314 436,100 13

Eastern Europe 249,852 254,842 266,610 279,498 284,518 291,757 17

World 6,814,343 7,159,590 7,493,112 7,823,112 8,120,681 8,424,774 24

Table 4.9 World food service outlets, by value and type, 2000–2004, US$97

% growth
Outlets 2000 2001 2002 2003 2004 2000–2004
Full-service restaurants 887,665 915,729 952,402 990,289 1,027,033 16

Quick-service restaurants 351,689 365,595 381,440 397,630 415,315 18

Cafés/bars 164,317 169,591 176,189 183,134 190,318 16

TOTAL 1,403,671 1,450,916 1,510,031 1,571,053 1,632,667 16

170 FOOD WARS

sales of just under $100 billion in 2002. This accounted for 36 per
cent of total restaurant industry sales. These 89 companies
operated 121,000 outlets.
In terms of type of outlet and value, full-service restaurants
dominate the world with more sales than quick-service restaur-
ants, cafés and bars, stand-alone sites accounting in 2000 for
almost 80 per cent of total food service sales. The primary driving
force of unit expansion has been the overseas growth of major US
chains such as McDonald’s, Yum! Brands (formerly Tricon) and
Burger King. One market study suggests that such chains per-
formed well ‘due to their fashionable image, reputation for good
hygiene, strong marketing power and ability to tap into the
increased demand for swift, convenient meal solutions at afford-
able prices’.98 Not surprisingly, there is growing competition
between food service and food retailing, with supermarkets
striving to develop what they call ‘home meal replacement’
(HMR) product offerings.
Growth in fast food has been phenomenal. While in 1970
Americans spent $6 billion on fast food, by 2000 they spent more
than $110 billion; they now spend more money on fast food than
on higher education, computers or new cars; more than on
movies, books, magazines, newspapers, videos and recorded
music combined.99
Table 4.10 illustrates the growth in the high-profile fast food
company Burger King, a US company which is now truly inter-
national and relies on consumers and countries outside the US
for its business success. The renamed Yum! Brands (the new
holding company for Kentucky Fried Chicken, Taco Bell, and
Pizza Hut) also has a new global reach (see Figures 4.6a and 4.6b).

Table 4.10 Burger King global presence, 1 January 2002100

Region Number of countries Number of outlets

present in
North America 2 8248
Europe 27 1657
Latin America 21 561
Asia Pacific 10 598
 THE FOOD WARS BUSINESS 171

Greater China
11%

Americas Asia Pacific

21% 43%

Europe –
South Africa
25%
Source: Company website, 2002

Figure 4.6a Yum! Brands, by region, 2002

Pizza Hut
33%

KFC Taco Bell

65% 2%

Source: Company website, 2002

Figure 4.6b Yum! Brands, global sales by fascia, 2002

But the global icon of the fast food industry remains McDonald’s,
which more than most companies carries the public profile that
personifies the Productionist paradigm. It is the world’s largest-
ever fast food chain with more than 30,000 outlets serving 46
million customers a day in more than 100 countries, and in 2002
it created system-wide revenues of $41.53 billion. (Table 4.11 lists
the top five countries for McDonald’s by number of outlets.)
But as the Productionist paradigm begins to destabilize, so
McDonald’s has looked less formidable. From a share price of just
172 FOOD WARS

Table 4.11 Global top five countries by number of

McDonald’s outlets, (2003)

1 United States 13,609

2 Japan 3773
3 Canada 1339
4 Germany 1244
5 Britain 1235
Total worldwide 31,129
Source: McDonald’s Annual Review 2003, http://www.investor.
macdonalds.com

over $48 in 1999, the company’s stock fell 72 per cent to around
$13.50 by February 2003, when the company announced its first-
ever quarterly loss in its 47-year history. In addition, McDonald’s
was in 2002 at the centre of high-profile litigation on behalf of a
class of obese and overweight children. It was alleged in a New
York suit, that the fast-food chain ‘negligently, recklessly, care-
lessly and/or intentionally’ marketed to children food products
that are ‘high in fat, salt, sugar, and cholesterol’ while failing to
warn of ‘obesity, diabetes, coronary heart disease, high blood
pressure, strokes, elevated cholesterol intake, related cancer,’ and
other conditions.101 Although this first case was thrown out of
court, in February 2003, such regulatory activity around fast food
and childhood obesity looks set to continue. The healthiness of
products like burgers and other foods associated with fast-food
culture such as snacks and soft drinks is likely to be increasingly
in the health firing line, and will present major challenges to the
food sector. It is why healthier options and some portion size
reductions are appearing in chains – not before time.
Meanwhile, food service, in its totality, continues to be one of
the most dynamic sectors of the food supply chain, despite the
evidence that food consumed away from the home is generally
higher in fat, and saturated fat, and lower in fibre and calcium
and overall nutrition than food eaten in the home. A US study
showed that, with eating out playing an increasingly large role
in the American diet, more nutritional activities are needed to
focus on improving food choices and quality.102 This ‘cultural’
dimension of new trends is central to any understanding of the
business dynamics of food service and its competition with
retailing. A tension is already apparent about whether people eat
 THE FOOD WARS BUSINESS 173

at home or on the streets, whether they eat in public or private

worlds, and whether they live to eat at home or eat and then go
home. The issue, as with elsewhere in the food supply, is who
does the cooking. We discuss this cultural dimension in more
detail in Chapter 5.

THE POLITICS OF GM BIOTECHNOLOGY AND

THE GROWTH IN ORGANICS

To illustrate further the far-reaching effects of the Food Wars on

shaping the fundamental scientific framework which is redefin-
ing the Productionist paradigm, and the dynamics of the Life
Sciences Integrated and Ecologically Integrated paradigms, this
section briefly traces the rise of both genetically modified and
organic agriculture. What is surprising about both is how recently
they have come into prominence. Although the modern-day
practice of organic agriculture has its origins in the 1930s, it is
only since the early to mid-1990s that there has been an exponen-
tial growth in the development of land under organic manage-
ment in areas such as the European Union. Likewise, it was only
from the mid-1990s that the world was introduced to GM techno-
logies and that wide-scale planting began, starting in the United
States.
We must make it clear here that in our three-paradigm model
we are in no way suggesting that the Ecologically Integrated
paradigm only means agriculture has to turn ‘organic’. There are
other ecologically integrated practices such as agro-ecology, low-
till methods and so on. Equally, the Life Sciences Integrated
paradigm does not mean that all production will be through GM
crops. Both paradigms are wider in scope than those narrow
conceptions. The paradigm concepts are used to suggest the key
drivers of a whole food system from inputs through to con-
sumption and to help identify human and environmental health
implications. Both are founded on the science of biology, and
biological sciences can have as much of a role to play in the
Ecologically Integrated paradigm as the Life Sciences Integrated
paradigm. ‘Soft’ biotechnologies could perhaps have a role to
play in the Ecologically Integrarted paradigm; but it is hard
to see how GM foods as currently being introduced from an
environmental, social and political perspective would fit in.
174 FOOD WARS

It is the Ecologically Integrated paradigm which best embraces

the broader goals of the organic movement in its aspirations to
protect environmental health and biodiversity, and to develop
traditional skills and techniques to improve agriculture. It also
espouses the application of low-till or ‘zero-till’ (ZT) agriculture
currently being pioneered in South Asia, which increases harvest
yields while reducing the use of water and herbicides.103 This
technique has been approved by the International Maize and
Wheat Improvement Centre, the International Rice Research
Institute and also Dutch and Chinese agencies, where herbicide
usage has been cut by over 50 per cent, water consumption by 30–
50 per cent and yields improved. The defining characteristic of
this paradigm is that, from local to global level, it attempts to find
genuinely sustainable solutions within ecosystems.
At the same time as organic products have set record-breaking
sales, organic production itself has come into head-to-head
conflict with the proponents of GM foods, as consumers increas-
ingly come to see ‘organic’ as a label for non-GM foodstuffs, over
contrasting methods of agricultural production. The battle has
become bitter since, under organic certification schemes, produce
cannot be labelled as ‘organic’ if it is found to be contaminated
by GM material. The global spread of GM crops has the potential
to make organic standards null and void through such con-
tamination. But the battle is deeper than this, with organics
squaring up to GM foods over the future direction and shape of
food supply.
Although there is not yet a consumer market for GM-pro-
duced foods, a growing consumer market already exists for
organic fresh produce and processed foods: GM foods entail the
more worrying technology, particularly for environmental
reasons and their impact on human health has so far mainly been
analysed on safety terms: that is, for immediate toxicity or for
allergic reactions. In this section we briefly consider both organics
and GM from a commercial perspective.

Organic production

One of the more dynamic and fast-growing food markets since

the mid-1990s has been the demand for ‘natural’ products and an
explosion in the rate of demand for organic produce, and market
 THE FOOD WARS BUSINESS 175

analysts are predicting that it will constitute one of the most

sustainable health-driven markets worldwide for decades to
come.104 In the US, for example, more than one-third of super-
market shoppers list organic foods, and more than half list
additive- and preservative-free foods, among the products they
wish to purchase to maintain health, with sales of just under $13
billion in 2001: organic foods at $6.95 billion (up 19.9 per cent
over 2000) and natural foods at $5.95 billion; and expected to
reach $25.8 billion in total by 2010.105 However, in 2002 no more
than 1.5 million hectares in the developed world were managed
organically, representing only a 0.25 per cent share of the total
agricultural area. As Table 4.12 shows, total area under organic
production in the same year was just 2.99 per cent in the EU and
there were just under 143,000 organic farms (Austria and Italy are
the European countries with the largest land areas devoted to
organic production at 8.68 per cent and 7.14 per cent respectively,
followed by the Scandinavian countries).
In terms of world markets, as Table 4.13 illustrates, sales of
organic foods in the US, Europe and Japan were less than 2 per
cent of total food sales in 2001, but significant growth is forecast
in the medium term to 20 per cent of total food sales: around $21
billion in global market value. Figures suggest an organically
managed area of around 22 million hectares in total, with retail
sales expected to grow to US$29–31 billion by 2005.107 To put the
organic market in context, in 2003 it was valued at less than half
of the total sales of Nestlé.
A strong selling point for organics is that they have been
confirmed to contain fewer chemical residues than other foods.
A review comparing foods grown under three regimes – organic,
Integrated Pest Management (IPM) and conventional farming –
found that: organically grown foods contained one-third fewer
residues than conventionally grown foods; conventionally grown
and IPM grown foods were more likely to contain multiple
residues than organic foods; residues in organic foods were
consistently lower than the conventionally or IPM-grown foods;
and conventional foods contained the most residues, IPM foods
the next and organic foods the least. Such potential health bene-
fits of organic foods, however, do not prevent them from being
contested. An interesting tussle went on in the UK, for example,
between the organic movement and the national Food Standards
Agency (FSA) shortly after the FSA was created in 2000 and in the
Table 4.12 Organic farming in Europe, 2000–2001106

European Union Date Organic area Agr utilized % Organic All farms %
(ha) area (000) farms (000)
Austria 31/12/2000 271,950 3497 8.68 19,031 226 8.42
Belgium 31/12/2001 22,410 1391 1.61 694 76 0.91
Denmark 31/12/2001 174,600 2646 6.20 3539 63 6.40
Finland 31/12/2000 147,423 2192 6.73 5225 91 6.60
France 31/12/2001 420,000 30,150 1.50 10,400 680 1.53
Germany 31/12/2000 546,023 17,389 3.14 12,732 434 2.93
Greece 31/12/2000 24,800 3465 0.72 5270 821 0.64
Ireland 31/12/2000 32,355 4415 0.73 1014 148 0.69
Italy 31/12/2000 1,100,000 15,401 7.14 60,000 2315 2.59
Luxembourg 31/12/2000 1030 127 0.81 51 3 1.70
Netherlands 31/12/2001 38,000 1961 1.94 1510 94 1.61
Portugal 31/12/2001 70,000 3812 1.84 917 417 0.22
Spain 31/12/2001 485,079 29,272 1.66 15,607 1208 1.29
Sweden 31/12/2000 171,682 3107 5.20 3329 90 3.70
UK 31/12/2000 527,323 15,858 3.33 3563 233 1.53
Total EU 4,032,675 134,683 2.99 142,882 6988 2.04
Note: Provisional results of an FiBL (Forschungsinstitut für biologischen Landbau) survey, June 2002; continual updating
Table 4.13 World markets for organic food and beverages108

Markets Retail sales % of total Expected growth – Retail sales

(million US$) food sales medium term % (million US$)
2000 2001
Germany 2100–2200 1.6–1.8 10–15 –
UK 1100–1200 1.0–2.5 15–20 –
Italy 1000–1050 0.9–1.1 10–20 –
France 800–850 0.8–1.0 10–15 –
Switzerland 450–475 2.0–2.5 10–15 –
Denmark 350–375 2.5–3.0 10–15 –
Austria 200–225 1.8–2.0 10–15 –
Netherlands 275–325 0.9–1.2 10–20 –
Sweden 175–225 1.0–1.2 15–20 –
Belgium 100–125 0.9–1.1 10–15 –
Other Europe* 400–600 – – –
Total Europe 7000–7500 – – 8500–9000
US 7500–8000 1.5–2.0 20 9000–9500
Japan 2000–2500 – – 2500–3000
Total 17,500 – – 21,000
Note: Official trade statistics are not available. Compilations are based on rough estimates. Retail sales in US$ are based on average exchange
rates. The figure for Japan is particularly uncertain. (This figure also includes non-certified products, for example some ‘Green Products’)
* Finland, Greece, Ireland, Portugal, Spain, Norway
178 FOOD WARS

wake of the BSE and other food scandals. The FSA launched a
public attack on organics, arguing that they were poor value for
money; there was furious riposte from the organic movement
and surprise from independent observers who felt that absence
of evidence is not valid bargaining power. The FSA has modified
its attack but persists that ‘there is not enough information
available at present to be able to say that organic foods are
significantly different in terms of their safety and nutritional
content to those produced by conventional farming.’109
By contrast, supporters of organics argue that organic agri-
culture provides more than just raw food and fibre; it is good for
the landscape and for rural development. This position has been
built into the multifunctional approach to the reform of the
Common Agriculture Policy (CAP): under reforms announced by
EU Commissioner Franz Fischler on 10 July 2002, there will be a
gradual switch under CAP from direct payments to farmers
for food production, to payments to farmers for their part in con-
servation and rural development. But, as one review has noted,
there are limits to what can be achieved by organics if it works
within the dominant food supply chain.110 The impact of com-
mercial contracts and specifications could outweigh the gains of
organic systems, and, given the distinct possibility of an intensi-
fication of organics, key issues for the organics industry will be:

l how to grow the market from its niche position in the de-
veloped world market, currently dominated by a very small
number of dedicated consumers who purchase the majority
of organic produce;
l how to make organic produce more affordable;
l how to extend the range of products from fresh produce to
more prepared foods;
l local versus export-driven production;
l extending the organic movement’s ‘value’ proposition, for
example to fair trade as well as to organic management;
l demonstrating and evaluating the human health benefits of
the consumption of organic produce.

GM foods: key themes and issues

Biotechnology – in all its forms – promises to be one of the

defining technologies of the 21st century, with GM foods proving
 THE FOOD WARS BUSINESS 179

to be one of the most controversial issues in the future of food

supply. GM biotechnology allows science to manipulate the
natural world at its most fundamental level: in comparison to the
organics industry, characterized by mainly small and medium-
sized companies, the early pioneers of the biotechnology in-
dustry are global corporations: Pharmacia (Monsanto), DuPont,
Syngenta, Bayer and Dow dominated agricultural biotechnology
in 2002.111 As a result, the rise of GM has been rapid. The first
commercial GM crop – tomatoes – introduced as recently as 1994,
was soon followed by insect-resistant potatoes and cotton in
1995, then insect-resistant corn, herbicide-tolerant soybean,
canola, insect-resistant maize and oil-seed rape in 1996.
From an agricultural point of view the commercialization of
GM crops so far has been spectacular, rising from 1.7 million
hectares in 1996 to more than 52 million hectares planted world-
wide by 2001 (see Figure 4.7). In 2002, there were around 58.6
million hectares of GM crops cultivated in 16 countries;112 68 per
cent of all plantings taking place in the United States, 22 per cent
in Argentina, 6 per cent in Canada and 3 per cent in China. One
company’s GM seed technology – Monsanto’s – accounted for 91
per cent of the total world area devoted to commercial GM crops
in 2001, and two genetically engineered traits (herbicide toler-
ance and Bacillus thuringiensis (Bt) insect resistance) accounted

80
70
60
million hectares

50
40
30
20
10
0
1995 1996 1997 1998 1999 2000 2001 2002 2003
year

Source: Clive James, ISAAA Brief No 30, Global Status of Commercial Transgenic
Crops, 2003

Figure 4.7 Globalplanting of transgenic crops, 1995–2003, million

hectares
180 FOOD WARS

for 52.6 million hectares planted to GM crops in 2001.113 For the

GM seed companies the technology is proving something of a
bonanza; they notched up sales of US$3.67 billion in 2001 with
forecast growth by more than 50 per cent to $5.57 billion in 2005.
Advocates of GM biotechnology point out a whole range of
benefits, including their potential to produce crops and foods
with enhanced health benefits. A report from the US Institute of
Food Technologists on biotechnology and food summarized
many of these; they included:114

l a more abundant and economical food supply for the world;

l continued improvements in nutritional quality, including
foods of unique composition for populations whose diets lack
essential nutrients;
l fresh fruits and vegetables with improved shelf-life;
l foods with reduced allergenicity;
l the development of functional foods, vaccines and similar
products that may provide health and medical benefits;
l further improvements in production agriculture through
more efficient production practices and yields;
l the conversion of non-productive toxic soils in developing
countries to productive arable land;
l more environmentally friendly agricultural practices (for
example, through improved pesticide usage).

It should be noted that many of these claims lack substantiation

and that some remain theoretical, whilst others are already reality
or approaching commercialization.115 Despite the widespread
introduction of GM crops, many research and scientific questions
remain to be satisfactorily answered. The 2003 report from the
International Council for Science (the ICSU) showed that,
hitherto, there had been no attempt to draw together the global
research base to establish where consensus lay and it pointed
to areas of disagreement and to gaps in knowledge requiring
additional research.116 The main area of disagreement was the
long-term environmental risks, which, in the UK, NGOs have
challenged, the most vocal group of which have been environ-
mentalists who argue that GM may irreversibly upset the balance
of nature, and that more ought to be known about its potential
impacts on flora, fauna and human beings. Additional issues
shaping the debate on GM include:
 THE FOOD WARS BUSINESS 181

l the impact of biotechnology on agriculture, the environment

and eco-systems (including intellectual property rights over
genetic materials);
l the role of experts in debates about science and technology;
l how to regulate new and emerging technologies;
l what is meant by consumer choice, including consumer
information, whether through labelling or other means; and
l how food production models are to be exploited under a
development banner.

Arguments for ecological caution are being expressed not only

by environmental campaigners but also from within mainstream
biological science. For example, in a measured review of GM
plants for food use published by the Royal Society of London
in October 1998, it was recommended that a ‘super regulator’
be appointed to monitor the wider issues associated with GM
development,117 and the UK government’s official advisers from
English Nature wrote to Prime Minister Tony Blair in 1999 as
follows:118
We are . . . very concerned about the effects that introducing herbicide
tolerant crops would have on biodiversity. These new varieties would
give farmers the ability to eliminate wildlife in crops where they
currently cannot easily do so. This type of genetic modification will
make farming even more intensive and is undesirable in the British
countryside where farming and wildlife must co-exist. We must learn
the lessons from the previous intensification of agriculture and its
disastrous effects on biodiversity.

In response, the UK government’s GM Science Review Panel has

now claimed that there have been no verifiable untoward toxic
or nutritionally deleterious effects of GM foods, despite remaining
gaps in their knowledge.119 Notwithstanding persistent consumer,
environmentalist and (some) expert concerns, the biotechnology
industry is quietly making sure that GM crops are almost a fait
accompli in world food supply: their rapid spread is making it
difficult for consumers to avoid them and the trend is possibly
irreversible. As biotech crops proliferate, the GM industry is
determined to win consumer acceptance. Monsanto, in May 2004,
withdrew its GM wheat in the face of consumer resistance and in
order to concentrate on less high-pofile consumer GM markets
than bread, such as cotton or oilseed rape. The industry was
boosted in 2001 when the UN Development Programme’s Human
182 FOOD WARS

Development Report came out in support of GM technologies as

helping to solve the developing world’s food problems, and
reduce world poverty;120 it stressed the unique potential of GM
techniques for creating virus-resistant, drought-tolerant and
nutrient-enhanced crops.121 The Report also pointed to an urgent
need for developing modern varieties of millet, sorghum and
cassava, which are staple foods for poor people in many develop-
ing countries, asserting that current debates over new biotechno-
logies mostly ignore the concerns and needs of the developing
world. The Report stated that Western consumers ‘naturally
focus on potential allergic reactions and other food safety issues.
People in developing countries, however, may be more interested
in better crop yields, nutrition, or the reduced need to spray
pesticides . . .’ Some critics of GM in the developing world were
irritated by such a patronizing tone and reassert GM as irrelev-
ant to their needs which are focused on access to land, securing
local markets and poverty alleviation.122, 123, 124, 125, 126
Many in the biotechnology industry, while acknowledging
that part of the public concern about GM crops is that they deliver
benefits to farmers only (agronomic traits), express great faith
that, once ‘second-generation’ GM crops come onto the market,
negative public opinion will fade. ‘Second-generation’ GM foods,
they argue, will deliver consumer benefits through the genetic
modification of fruits, root and leaf vegetables and grains, with
enhanced nutritional and health-promoting properties for both
humans and eventually even animals.

SUMMARY AND CONCLUSION

In this chapter we have tackled the historical forces, goals and
challenges of production, distribution and processing, highlight-
ing how corporate interests provide a main focus of the Food
Wars. The emergence of unprecedented power within the supply
chain shapes how business diverges in its approach to the emerg-
ing paradigms, and how key trends shaping the food economy
during the early 21st century point to health being a key concern
for some business. For many companies, health has become
purely a marketing tool but for others it is a commitment. For the
future of food, we foresee the following dynamics:
l There will be a continued consolidation of food power into
the hands of supermarket chains. They currently dictate the
 THE FOOD WARS BUSINESS 183

competitive environment in which the food chain operates

and they are extending their influence globally, and this can
be contained only by political intervention.
l Food service is growing in importance and absorbing more
consumer expenditure. This growth will blur the business
boundaries between manufacture, retailing and catering.
l ‘Sustainable’ issues are of mounting importance and will
climb up the food economy agenda as evidence of environ-
mental challenges deepens.
l There will be continued consolidation of agriculture and
agribusiness, a continuing decline in the numbers of small
farmers and widespread but contested use of GM technology.
l The ‘localization’ of global food corporations will grow. As
food transnationals become more dominant in key food
categories, they will be increasingly challenged to meet ‘local’
demands and consumer needs.
l There will be escalating pressure on the food sector to innov-
ate and add value in order to deliver returns for financial
markets as well as to meet consumer demands.
l There will be continuing fragmentation of markets with a
mass market for ‘niche’ products.
l Health and nutrition will become more important across the
food supply chain, although the meaning of health will be
defined differently to suit different interests.
l There will be a ‘green shift’, away from intensification of food
supply to extensification schemes such as the promotion of
organic and natural products.
l New technologies, especially in respect of GM, will offer to
alleviate the shortcomings of the Productionist paradigm.
l There will be consumer resistance to what is seen as the
‘corporate takeover’ of food and growing unease about low-
waged labour and other ethical issues.

While not wishing to downplay the importance of science and

technology to the future of food supply, we suspect that cultural
and social values will play an increasing role in how the food
supply chain develops, and the role of science in society will be
more critically assessed and evaluated. The last two decades of
the 20th century witnessed consumers flexing their opinionative
muscles and reasserting their rights, but whether consumers really
exert effective collective power as forces within the food supply
chain remains to be seen.
184 FOOD WARS

CHAPTER 5
THE CONSUMER
CULTURE WAR
‘There is hardly anything in the world which some man cannot make a
little worse and sell a little cheaper, and the people who buy on price only
are this man’s lawful prey.’

John Ruskin (1819–1900)

CORE ARGUMENTS
In an ideological world where the consumer is ostensibly
sovereign, the notion of a ‘food culture’ is a more robust
way of understanding people’s beliefs and behaviours
regarding food: the concept is central to food and health
and to which ideas about diet will dominate the con-
sumer’s mind. Business spends huge sums of money trying
to mould and respond to consumer aspirations: by con-
trast, governments deliver huge amounts of rhetoric but
very little money on urging consumers to change their
diet. The ‘consciousness’ industries are now competing
with public health education to shape food culture and
food policies. That a homogeneous ‘food culture’ simply
no longer exists is becoming a new reality for food policy.

THE BATTLE FOR MOUTHS AND MINDS

Food companies today all want to describe themselves and their
activities as ‘consumer-led’, and the Food Wars are played out in
the arena of public consumption and the imagery and media that
help shape it. The battles here are not just for the mouths of
 THE CONSUMER CULTURE WAR 185

consumers, but increasingly for their minds. As we saw in the last

chapter in the case of Coca-Cola and Unilever, there is con-
siderable emphasis by food companies on getting the consumer
to form an emotional bond with products and companies.
A struggle is underway between food processors selling their
branded dreams, caterers luring consumers to their food offer-
ings often through strategies that owe more to the entertainment
industries than to food (a trend called ‘eatertainment’ in the US),
and supermarkets trying to outdo both. There is now a belated
rearguard action by some farmers who are attempting also to
inject their imagery and produce into this consumer mix.
This chapter maps out the new consumer landscape as it
applies to our core theme of food and health and the policy
responses. This is difficult terrain. Whereas conventional
marketing and management theory focuses on narrow market
definitions of a ‘food consumer’ and the pursuit of consumer
sovereignty, we think it more valuable to investigate and under-
stand a wider notion of food culture and to situate health within
it. It is only by understanding how food culture is being shaped
by powerful food supply chain forces, and their responses to con-
sumer understanding of food and health, that policy-makers can
hope to create realistic strategies. The current policy emphasis on
health education as the means for tackling diet-related ill health
is out of touch with both business realities and food culture.
The notion of ‘food culture’ is also useful for expressing how
food beliefs and behaviours are socially framed: it refers to a
constellation of socially produced values, attitudes, relationships,
tastes, cuisines and practices exhibited through food. To explore
food culture requires us to acknowledge the meanings that
individual people and population groups attach to food.1 When
people sit down to a meal together, every action they take –
sitting on chairs, using plates and cutlery, the order of food, the
type of food they choose, where and what they eat and how much
– is an indicator of food culture.2 Food culture comprises both
social ‘cement’ – binding groups together with shared assump-
tions – and opportunities for difference and distinction:3, 4 people
express their identities, and classes through food and derive
cultural meanings from it.5
From the point of view of our present concerns, we reiterate
that food culture is not homogeneous. Consumers often hold
opposing food beliefs: they may welcome some innovations but
186 FOOD WARS

resist others; they say that they are concerned about health, but
do not always want to change diet-related behaviour for health
reasons alone; they judge food by its price but also by its quality.
Consumer food culture is immensely complex, being multi-
dimensional and constantly changing: food patterns, tastes and
beliefs are now in a permanent state of transition; existing and
older food cultures are semi-permanently under assault,6, 7 partly
driven by willing change and partly by changes stemming from
the restructuring of the food economy and its major players (see
Chapter 4).
More than any other factor including science, we see the
current food culture as driving the demise of the Productionist
paradigm and shaping the future success or otherwise of the Life
Sciences Integrated and the Ecologically Integrated paradigms.
Food culture is in tension with business philosophies and state
policy, as well as with the ways people have traditionally pur-
chased, prepared and consumed. Our thesis here is that culture
is a key to understanding the dynamics between the supply chain
and health; but culture is not a consistent entity.8, 9

FOOD AND HEALTH: A DONE DEAL FOR

THE CONSUMER?

According to some market research, consumers already see the

connections between food and health, and in many cases make
choices based on their understanding of diet and health. In the
1990s, a large study for the European Union of 14,331 people in
15 countries found that, while overall, respondents saw quality,
price and taste as the main factors affecting their food choice,
health was close behind.10, 11, 12, 13 The same survey found that the
majority of EU citizens are happy with their diets and see no need
to change them, despite a third of respondents reporting that they
had already made changes for health reasons; that young people
see convenience as the greatest influence on their choice of food,
while older people are most interested in food’s health attributes;
that women are more interested in health than men; and that
Northern Europeans tend to focus on fat, fruit and vegetables and
the need to maintain variety and balance, while Southern Euro-
peans express a preference for fresh and unprocessed foods.
 THE CONSUMER CULTURE WAR 187

Such findings are also supported by more commercial market

research. The US company HealthFocus, for example, surveyed
consumers in both the US and selected European countries.14
Their results suggested that 74 per cent of European shoppers
were ‘health active’, to use their terminology, (those who see a
connection between their dietary choices and their health and
believe that they can influence their health condition by the
choices they make, both for themselves and for their families),
and that 94 per cent of American shoppers were ‘health active’.
The survey found that four out of five Western European
shoppers are eating healthy food because they want to and feel
that their eating habits are already healthy and do not require
major improvement or changes to their diets. HealthFocus found
that Europeans are unwilling to make diet or food compromises
for health benefits. They want to eat healthfully, they feel they do
eat well, but they won’t go out of their way to make any major
changes in their diets or activity levels in order to improve their
long- or short-term health. HealthFocus advised marketers:
‘Don’t expect consumers to change their behaviour. Fit your
solutions to their current eating habits and lifestyle needs.’
Linda Gilbert, president of HealthFocus, said:

One lesson is to speak to the internal benefits that shoppers realize

from making healthy choices, more than external rewards. In the U.S.
we have found the most compelling benefits are often anchored in
emotions and lifestyles. Clearly consumers recognize that nutritional
needs differ by individual based on gender, age, health condition and
more. Product developers need to customize products and marketers
need to personalize communications so that shoppers can purchase
products that are ‘right for me’.15

The same HealthFocus research showed that European shoppers

are concerned about pesticides in food, food irradiation and
genetically modified organisms; also about food preservatives,
highly processed foods and food biotechnology. Such concerns
over quality and adulteration suggest consumers awareness that
is often not acknowledged within the policy (and business)
context. Policy-makers too readily subscribe to the view that all
that consumers are concerned with are macro-issues such as
price, convenience and time, when, in fact, consumer research has
suggested that they have a complex set of demands and aspira-
tions for food in which health plays a significant role.
188 FOOD WARS

A report commissioned by Food Science Australia in 1999

presented a ‘snapshot’ of opportunities for the development of
food products which had health- and vitality-enhancing proper-
ties. It predicted, up to 2010, the following market opportunities:

l greater consumer interest in Asian, herbal and alternative

health and vitality products as societies become more multi-
cultural;
l a shift in consumer perception from food as fuel to food as
preventative medicine;
l growing consumer interest in personal health advisers, both
human and digital;
l greater emphasis on ‘organic’ production as a source of
competitive advantage;
l increased regulation of health claims on food products;
l the increased privatization and politicization of health care;
l new technologies, such as nutraceuticals, emerging as the
focus of a food industry ‘bandwagon’.16

With the results of such studies around the world pointing to

health as one of the key consumer concerns driving food markets
– from what they eat to how it is produced – policy must address
the adequacy of the food industry’s response of developing one-
off products containing ‘health attributes’. Much of the food
industry’s answer to the health challenge is short term and
simplistic, merely adding more vitamins and minerals, fibres or
various proteins, or so-called nutraceuticals to products, thereby
treating health as a subordinate goal and a discrete entity, rather
than as intrinsic to food culture and the entire food supply chain.
Health still tends to be seen as an individual corporate character-
istic rather than a goal for the entire food culture. Truly to meet
the needs of consumer health and build an effective public health
strategy, the food industry will have to develop a new business
culture of health. Just producing new one-off products with
health attributes, however successful in the marketplace, cannot
constitute a public health strategy.

CONSUMING WANTS AND NEEDS

The relationship between the consumer and food can be fraught.
Affluent societies are now understandably concerned about
 THE CONSUMER CULTURE WAR 189

developing obsessions with body images:17 media messages extol

the beauty of waif-like fashion models on the one hand, and the
dangers of anorexia on the other. The new food and health
zeitgeist is an eternal triangle linking ‘health’, ‘food’ and ‘beauty’.
Food, beverage and cosmetic companies are now busy dreaming
up new products for consumers that will deliver the perceived
benefits and imagery represented by this new consciousness.
Debates have, of course, raged for decades about the morality of
consumerism,18 its impacts on global divisions19 and the environ-
ment,20, 21 its myths and so on.
Global food marketing is putting before people an awesome
offer: endless food choice for very little effort, and now at last, the
new global food machines – ‘intellectual property’ as well as
actual techniques – are meeting resistance: after decades of fast
food, there is a fast-growing ‘slow food’ movement;22 after decades
of the legal adulteration of food, there is now a burgeoning
market for natural foods; after decades of enticing consumers to
eat world cuisines, there is now a counter-move to return to
localism, regional foods and real cooking. It is not fanciful to see
the revolt over GM foods, for instance, as a popular uprising
against imposed new technologies.23 There is growing consumer
resistance to the perceived corporate and scientific arrogance of
companies patenting a rice, for example.24 With the food com-
panies’ global brands so ubiquitous, it is not surprising that they
are becoming sometimes subjects of a citizens’ backlash.25, 26
In addition, today’s consumption is tomorrow’s waste, both in
the form of excrement and packaging. As we will show in the
next chapter, energy used in food production is astonishingly
wasteful in itself. Consumption affects climate change because
of use and abuse of fossil fuels. No civilization ever before has
had or expressed this capacity to threaten its own biosphere so
extensively.

‘BURGERIZED’ POLITICS
Food is intensely personal: it is, and it conveys, our identity,
which is why these deep meanings are so carefully monitored
and tracked by food companies, building on the thinking first
developed by Sigmund Freud (an explanation of why so many
psychologists are employed in the consciousness and marketing
190 FOOD WARS

industries). Everyone likes to think that they control their own

diet, that it is theirs by choice and tradition; we like to think that
the tomato is Italian and that rhubarb is English, for example. Yet
even a cursory review of food history reminds us that there is
nothing new about food globalization: food culture follows trade,
which, in turn, follows people and culture. Take the potato, which
came from the Andes:27 it met a combination of resistance and
apathy when introduced to Europe by Sir Walter Raleigh in the
17th century, but now the chip or ‘fries’ drive global fast-food
production so closely associated with America. In fact, the US
love affair with fries came back from World War II with returning
troops enamoured with ‘French fries’ – hence the name.28 The
potato like many foods was projectiled by trade into the mass
food culture worldwide: the British introduced the potato to
India where it is now a staple alongside rice; they also introduced
it to Ireland, where its crop failures due to monocropping and
bad weather engendered the dreadful Irish Famine of 1845–1846;
it was the culinary ‘technical fix’ for British oppression, grown by
peasants on smallholdings while absentee British landlords, who
milked the land and put little back, relied on them doing so:
potatoes gave high yield on low acreages. When grown in mono-
cultures, however, potatoes are highly vulnerable to decimation
by the blight.29
Few major food commodities are heavily cultivated and eaten
solely where they originate, their so-called ‘Vavilov’ centres
(named after the Russian scientist Vavilov who first mapped the
botanic origins of species to centres of the world). Culture and
production have a symbiotic relationship. Cane sugar, a native
of Polynesia, spread to India, China and elsewhere but only
became a global commodity and staple ingredient and food in the
industrial diet through the slave trade in the notorious ‘golden
triangle’ between the Caribbean, Africa and Europe.30, 31 Wheat
originated in Africa, but it is US and European surpluses via
the GATT (the Global Agreement on Tariffs and Trade) which
are now entering Asia to win over the rice-eaters of Asia to its
charms. Food in this sense is both cultural ambassador and ‘fifth
columnist’.
What is new today about the role of food and its ‘cultural
dissemination’ is the pace and scale of corporate influence in the
process of change. Colas and burgers are now synonymous with
America, and ‘Mcdonaldization’ – what we call ‘burgerization’ –
 THE CONSUMER CULTURE WAR 191

used as shorthand for the modern bureaucracies of society.32 The

burger has become a symbol of modernity and the triumph of an
American mode of eating, a metaphor for how rational, bureau-
cratic society can command the production of any good and the
fulfilment of any need. The burger symbolizes a society on the
move, constantly seeking new markets, travelling large contin-
ents, forced to eat ‘on the hoof’ and at speed.33 In cultural terms,
sweet, bland foods are usurping gustatory diversity; palates are
kept at the pre-adolescent stage of development. ‘Comfort’ foods
sell. Sugary drinks triumph.
Food’s capacity to be changed – its ‘plasticity’ – is why it has
been such a perennial threat to those in control, whether govern-
ments, companies or land-owners. The relationship between
consumers and food is uneasy. Companies know only too well
that consumers can be fickle but customer loyalty is the dream
of any firm; governments know that it is worth paying more than
mere lip-service to consumer opinion. At the same time, if con-
sumers led opinion, there would be no room for politics. The
legacy of the French Revolution in which all citizens vote, not just
the free as in Athenian democracy under which slaves had no
rights, is replaced by a marketplace ‘ballot box’ which occurs
every time the consumer buys and pays for a good or service. The
notion of citizenship is thus being redefined as a purchaser whose
‘(purchasing) ballots . . . help create and maintain the trading
areas, shopping centres, products, stores, and the like’.34 Buying
becomes tantamount to voting, market surveys the nearest thing
that exists to expressions of the collective will.35 It follows that the
more wealth or purchasing power the consumer has, the more
‘votes’ she or he gets.
Indeed the parallel between workers, who without organiza-
tion (trades unions) are easily outmanoeuvred in the wage market,
and consumers has been much commented on. The French socio-
logist Jean Baudrillard, for instance, stated acidly in 1970:

Overall . . . consumers as such are lacking in consciousness and

unorganized, as was often the case with workers in the early nineteenth
century. It is as such that they are everywhere celebrated, praised,
hymned by ‘right-thinking’ writers as ‘Public Opinion’, that mystical,
providential, sovereign reality. Just as ‘the People’ is glorified by
Democracy provided that it remains the people (and does not intervene
on the political and social stage), so consumers are recognized as
enjoying sovereignty [. . .] so long as they do not attempt to exercise it
192 FOOD WARS

on the social stage. The People are the workers, provided they are
unorganized. The Public and Public Opinion are the consumers,
provided they content themselves with consuming.36

Is that the role of consumers? To consume and not to ‘intervene’?

We think their role has developed significantly and that certainly
in the food world, consumers have begun to ‘exercise’ their
muscles and to threaten.

THE NEW CONSUMER WEB AND

COMPETING MODELS
Most countries have had a long struggle over who controls food:
between ‘democratizing’ food culture and the imposition of a
top-down control system.37 Much depends upon whether one is
rich or poor, living in a developed or developing country. The
reality of modern food consumption is that the dominant food
culture is pulling one way, while reason and caution urge other
policy goals: the mantra of ‘choice’ pulls one way, the necessity
of environmental sustainability another. The language is of
consumer sovereignty; the reality is of increasing market con-
centration. These contrary patterns are shown in Table 5.1 which
contrasts the ‘dominant’ model with ‘alternatives’. Even
though the term ‘alternative’ is used, these are just as real, as the
‘dominant’ models and have policy ramifications; it remains
to be seen which pattern emerges as dominant overall. The
challenge for policy-making is to reconcile these contradictory
demands and to make a definite choice. We see this list as key
indicators for which paradigm is adopted within food and health
policy and thinking.
At its most basic level, consumerism offers a dream of total
choice. The neo-liberal economic model has ushered in an era in
which consumers, rich ones in the main, can ‘browse the world’
in their local supermarket without even having to travel; the
world’s food is literally coming to their shopping basket and
table. The reach of retail giants, as we showed in the last chapter,
is a new food colonialism: instead of owning the land, as the great
European imperialists did, the 21st century food empires own the
trade routes and marketing channels. At the same time as this
 THE CONSUMER CULTURE WAR 193

Table 5.1 Competing models for patterns of food consumption38

The dominant model The alternative model

globalization localization
urban/rural divisions urban–rural partnership
long trade routes (food miles) short trade routes
import/export model of food security food from own resources
intensification extensification
fast pace and scale of change slow pace and scale of change
non-renewable energy re-usable energy
few market players (concentration) multiple players per food sector
costs externalized costs internalized
declining rural workforce vibrant rural population
monoculture biodiversity
one-track agriculture multifunctional agriculture
science replacing labour science supporting nature
scientific farming organic/sustainable farming
biotechnology indigenous knowledge
processed (stored) food fresh (perishable) food
food from factories food from the land
hypermarkets markets
de-skilling skilling
standardization ‘difference’ and diversity
niche markets on shelves real variety on field and plate
people to food food to people
fragmented (diverse) culture common food culture
created wants (advertising) real wants (learning through culture)
brands local distinctiveness
‘burgerization’ local food specialities
microwave re-heated food cooked food
fast food slow food
individualized food commensality/shared food
private intellectual property common goods
‘new’ food economy old ways of food economy
footloose production fixed location for production
food from anywhere bio-regionalism
rapidly changing artificial nature slowly changing nature
global decisions local decisions
top-down controls bottom-up controls
dependency culture self-reliance
health inequalities widening health inequalities narrowing
social polarization and exclusion social inclusion
consumers citizens
de- or self-regulation state/public regulation
food control food democracy
policy segmentation policy integration
194 FOOD WARS

food trade has grown, so has the travel of people away from their
homes: an estimated 600 million people travel abroad each year
(and run an estimated 20–50 per cent risk of contracting a food-
borne illness when they do so).39
Modern food culture thus offers huge choice for some, but
also little for many:40 it promises information on labels but pro-
vides little education with which to interpret them.41 In the far
north of Russia, one of us has had discussions with public health
specialists wanting to know what these Western European labels
mean. As Western food products flood eastwards over the former
Iron Curtain, the vocabulary needed to interpret the packaging
devalues existing cultures and imposes new constraints: for
example, an ‘E’ label designates EU approval of an additive;
ingredients are listed in order of decreasing quantity by weight;
and so on. These questions indicate the cultural drift being
pushed from West to East by powerful food companies looking
for new markets, and often aspired to as modernity by consumers
in the East. Wants are being subtly shaped while needs remain
unmet. Local foods become culturally suspect while foreign and
particularly Western food becomes chic.42 Food is becoming a
commodity which allows whims and fashion to determine its
consumption; consumer culture is implanting what environ-
mentalists call its ‘footprint’:43 elite food consumer culture is
leaving a deeper and deeper imprint in the sands of history.
Bottled water is an example of a commodity which travels the
globe and which is hugely energy-wasteful, while modern life-
styles threaten local water sources and water shortages are turn-
ing the goal of clean water for all into a commodity scramble.44, 45
The paradoxes and idiocies of the emerging global food culture
are legion.

‘SCHIZOPHRENIC’ CONSUMERS?
In theory, modern consumers can now choose to remain victims
or to be active citizens, finding meaning and enchantment from
food in an otherwise disenchanted world.46 In reality, however,
only affluent consumers have significant food choice; middle-
income consumers have rather less, and the poor next to none.
Table 5.2 gives a conceptual classification of these new global
 THE CONSUMER CULTURE WAR 195

Table 5.2 World consuming classes47

Category of High Middle Poor

consumption
Population 1.5 billion 3 billion 1.5 billion
Diet meat, packaged grain, clean insufficient
food, soft drinks water grain, unsafe
water
Transport private cars, air bicycles, bus walking
Source long-distance some long-distance local food;
foods; hypermarket food; local shops local shops
and delicatessen/ and markets and markets
specialist shops
Materials throwaways durables local biomass
Choice big choice; global sufficient, regional limited or
horizons horizon absent, local
horizon
Environmental high considerable low
impact

consuming classes. (Ironically low-income consumers can have

a considerable impact on the environment, chiefly by burning
wood to cook.) The purpose of the table is to highlight how the
more affluent, by dint of purchasing and consuming more,
exhibit the greater environmental impact.
Immigration is another well-established mechanism of food
cultural change. Immigrants bring their food tastes and cultures
with them. It is why setting up restaurants selling their food
culture and cuisine is such a common first or second generation
commercial enterprise. It is why one could eat good Ethiopian
food in Washington, DC, not long after the famine.48 France has
long had a range of excellent African food. The UK is a second
home to marvellous Indian sub-continental foods. In fact, the
ethnic food market in the UK had a retail value of more than £900
million in 2002,49 and today English food is defined as much by
‘chicken tikka masala’ as by the formerly ubiquitous but now
declining British ‘fish and chips’.
In the public sphere, the food industry may appear to bow
before the consumer, yet this facade is thin: the marketers, opinion
pollsters and focus group consultants who daily probe con-
sumers’ tastes, fetishes and aspirations will privately admit that
196 FOOD WARS

there is no one such type as ‘the consumer’; market research

highlights how, over and above demographic givens such as
gender, age and ethnicity, consumers are divided by income,
social class, ideology and desires; they are fragmented in their
tastes in ways that make mass markets hard to corral. The public
wants good safety and environmental practices in theory but is
often unprepared in practice to pay the extra costs that tougher
standards entail.
A product specialist for a top UK food retailer conducted a
detailed tracker survey on food integrity which showed con-
sistent rises in concerns about issues such as pesticides, GM
foods, additives and health issues generally: echoing the US
psychologist Abraham Maslow’s hierarchy of human needs (that
humans cannot move on to more mature emotional states until
‘lower’ and more basic needs have been fulfilled),50, 51 the survey
produced a pyramid model to explain rising consumer aspira-
tions with regard to food (see Figure 5.1). At the base is the
demand for food to be safe – the sine qua non of contemporary
food supply management. But, as people get more affluent, they
demand features further up the pyramid, features which also
➤

Ethics

Environment

Animal welfare

Mislabelling

Unnatural production

Healthy nutrition

Food safety

Figure 5.1 A model of consumer food aspirations used by a leading

UK food retailer
 THE CONSUMER CULTURE WAR 197

have a strong generational dimension. This hierarchy, also recog-

nizing young consumers’ demands, is being planned into that
company’s long-term strategy.
All medium to large food companies ceaselessly research the
consumer and incorporate findings into their product planning
and strategy. There is a veritable army of market researchers,
consumer monitoring services and consultants whose entire
existence centres on tracking shifts in consumer consciousness,
aspirations and needs. Most large companies conduct and/or
buy such research on a continuing basis. Market researchers and
advertisers are very good at (re)packaging such work, producing
ever-more clever categories of consumers in market-led groups
to tailor products to suit their differences. They assume the
standard socio-economic differences and overlay aspirational
group differences to yield categories. The homogeneous ‘con-
sumer’ is a myth that the food industry realizes no longer exists.

MOULDING FOOD CULTURE

One of the most remarkable changes in consumer food culture is
the sources people use for their information about food. Home
experience may still be the initial ‘fount’, but there are now many
competing channels of information: advertising, sponsorship,
formal education, the media and the internet, and peer groups.
The media has often been the butt of blame from the food
industry if their particular industries are not portrayed in a
favourable light. Notwithstanding, the global food industry
spends hundreds of millions of dollars annually on advertising,
public relations and other promotional activities. The battle over
GM foods is an obvious example of where things have unravelled
in the management of consumer consciousness. At the 2000
International Food and Agribusiness Management Association
conference, for example, speakers claimed that more money
needed to be spent on persuading consumers of GM foods’
attractions. ‘Perhaps the greatest challenge we face lies not in the
area of technology but in marketing,’ David Rowe of Dow
AgroSciences, a unit of Dow Chemical Co, told a session on food
technology;52 he called for more investment in consumer needs
and education. Seven companies and the Biotechnology Industry
198 FOOD WARS

Organization formed the Council for Biotechnology Information,

which has developed a $50 million, three- to five-year agenda for
building public support for high-tech foods. Another dele-
gate told the conference of the need to ‘lose the term GMOs’
and to use ‘food biotechnology’ or ‘agricultural biotechnology’
instead.53 Similarly, in the area of functional foods and nutra-
ceuticals it is now a common assumption that it is not more
science that is needed for market success but better communica-
tions and being able to ‘talk’ the language of consumers.54 The
reality of this approach, of course, in many cases is that it is
putting marketing hype over health substance.

FOOD ADVERTISING AND EDUCATION

There has over recent decades been persistent concern about the
targeting of young people by advertisers;55 the advertising
industry has responded by sponsoring health research in order
to dispel its negative image.56, 57 In the UK, however, around half
a billion pounds a year continues to be spent on food advertis-
ing, most of it for sugary, fatty, ‘fun’ foods. Table 5.3 shows how
the healthier foods – fruit and vegetables – receive negligible
advertising support, and Table 5.4 details the UK advertising

Table 5.3 Adspend by food category, UK58

Food category £000s

Bread and bakeries 11,124
Biscuits, cakes, pies and pastries 14,420
Cereals: ready-to-eat 69,219
Dairy products 55,489
Fish: canned, fresh and frozen 5,040
Frozen ready-to-eat meals 18,600
Fruit: fresh, canned, dried and frozen 3,506
Margarine 23,148
Meat and meat products 24,041
Potato crisps and snacks 34,221
Sauces 40,187
Vegetables: fresh, frozen and canned 13,255
Total advertising for all foods 471,497
 THE CONSUMER CULTURE WAR 199

expenditure on leading food and drink brands. (It is interesting

to note that, although the brands are diverse, it is a narrow range
of agencies that shape the advertising and communication mes-
sages.) Table 5.5, by way of contrast, gives examples of advertising
expenditure by leading US food corporations.
The success of businesses – and particularly of brands –
depends upon consumers being predictable. A single industry is
staffed by an army of professionals, from psychologists to home
economists, dedicated to studying, analysing and squeezing
consumers into ‘pigeon holes’ – or ‘niches’ in business parlance
– better to predict and manage them. As Sir Michael Perry, former
head of Unilever, said in 1994 in a keynote presentation to the UK
Advertising Association:

Our whole skill as branded goods’ producers is in anticipation of

consumer trends. In earlier appreciation of emerging needs or wants.
And in developing a quality of advertising which can interpret
aspirations, focus them on products and lead consumers forward [our
emphasis].61

The food industry was a strong supporter of, and beneficiary

from, the European Single Market, legislated in the Single Euro-
pean Act of 1987. The cost savings it promised from coordinating
from diverse national food standards was calculated to save the
chocolate industry 30 per cent, the beer industry 22 per cent, the
ice cream industry 12 per cent and the pasta industry 9 per cent.62
(It is not certain whether these cost savings were ever passed on
to consumers because these industries immediately entered a
period of mergers and acquisitions to take benefit of massive new
markets.) Meanwhile, implementation of the other side of the
Single Market ‘bargain’ – giving consumers more information
and better labelling – was remarkably slow; it was not for another
12 years, for example, that quantitative ingredients labelling
(QUID) was introduced.
The food industry is highly skilled in using diverse media to
present itself in a favourable light, from producing educational
materials for schools to linking up with charities.63 This type of
promotion is now global. In 2002, McDonald’s and UNICEF
launched a fund-raising initiative called ‘World Children’s Day’,
held on 20 November, the anniversary of the UN adoption of the
Convention on the Rights of the Child in 1989. On that day in 121
Table 5.4 Adspend by food companies in top 50 UK brands59

Brand Manufacturer Sales year to Creative agency Adspend (£)

April 2000 (£m)
Coca-Cola Coca-Cola Company 635–640 Publicis 26,575,202
Nescafé Nestlé 335–340 McCann-Erickson 22,662,100
Weetabix Weetabix 90–95 Lowe Lintas 16,631,619
Budweiser Anheuser-Busch 100–105 BMP DDB 13,135,168
Birds Eye Wall’s Ice Cream Birds Eye Wall’s 130–135 McCann-Erickson 11,712,507
PG Tips Van den Bergh 125–130 BMP DDB 10,600,844
McCain Chips McCain Foods 115–120 D’Arcy 9,092,710
Kit Kat Nestlé Rowntree 175–180 J Walter Thompson 9,077,997
Fosters Scottish Courage 90–95 M&C Saatchi 8,904,286
Müller Müller 230–235 Publicis 8,608,144
Tango Britvic Soft Drinks 90–95 HHCL & Partners 8,289,474
Tetley Tetley GB 110–115 D’Arcy 8,103,598
Sunny Delight Procter & Gamble 140–145 Saatchi & Saatchi 8,006,084
Mars Bar Mars 110–115 D’Arcy 7,968,903
Walkers PepsiCo 455–460 Abbott Mead Vickers BBDO 7,672,949
Pepsi PepsiCo 190–195 Abbott Mead Vickers BBDO 7,508,165
Dairylea Kraft Foods 90–95 J Walter Thompson 7,109,456
Lucozade SmithKline Beecham 120–125 Ogilvy & Mather 6,762,215
Flora Van den Bergh 110–115 Lowe Lintas 6,527,470
Brand Manufacturer Sales year to Creative agency Adspend (£)
April 2000 (£m)
Ribena SmithKline Beecham 170–175 Grey 5,601,488
Stella Artois Whitbread 255–260 Lowe Lintas 5,539,885
Carling Bass Brewers 145–150 WCRS 5,178,819
Pringles Procter & Gamble 135–140 Grey 4,055,268
Robinsons Britvic Soft Drinks 170–175 HHCL & Partners 3,769,187
Galaxy Mars 80–85 Grey 3,725,219
Anchor New Zealand Milk (UK) 90–95 Saatchi & Saatchi 2,782,055
Cadbury Dairy Milk Cadbury 160–165 TBWA GGT Simons Palmer 2,780,558
The Famous Grouse Highland Distillers 85–90 Abbott Mead Vickers BBDO 2,772,168
Smirnoff Red Label Diageo 90–95 J Walter Thompson 2,441,745
Lurpak Arla Foods 100–105 BMP DDB 2,269,430
Heinz Baked Beans Heinz 120–125 Leo Burnett 2,198,289
Heinz Canned Soup Heinz 130–135 Leo Burnett 1,901,585
Ernest & Julio Gallo E&J Gallo Winery 85–90 Mountain View 1,447,893
Birds Eye Frozen Vegetables Birds Eye 105–110 McCann-Erickson 899,824
Bells 8 Year Diageo 110–115 Court Burkitt & Co 3,600
Birds Eye Frozen Poultry Birds Eye 110–115 N/A N/A
202 FOOD WARS

Table 5.5 Adspend by leading food companies, US60

Rank MegaBrand Total Spend $000s

1 McDonald’s 655,743
2 Wal-Mart Stores 375,331
3 Coca-Cola Company 345,090
4 Kraft foods (Altria) 315,715
5 Burger King (Diageo) 306,147
6 Pepsi-Cola (PepsiCo) 273,135
7 Big G Cereals (General Mills) 265,749
8 K-mart 250,284
9 Quaker Oats Co (PepsiCo) 249,484

countries, McDonald’s mounted a variety of activities and pro-

motions in aid of local children’s organizations. This serves as an
example of the ‘global going local’ strategy outlined in the last
chapter.64
One of the serious points of tension between commerce and
government has been food labelling. Labelling is a mantra for
consumerism: its role is to provide consumers with information
upon which to be able to make informed judgements and choices,
thereby encouraging market efficiencies yet there is little internal
consistency in its application to food. In practice, what goes on a
label becomes a subject of intense politicking. One British senior
civil servant went on record as saying that in effect the UK
government in the 1980s and early 1990s regarded food policy
as no more than what information could or could not appear
on a label.65 Within Europe, for instance, the presence of food
additives has to be declared, but not pesticides.66 If a food has
been irradiated, a declaration on the label is required only if the
ingredient is more than 1 per cent by weight of the final product.
This allows irradiated pepper and spices (commonly irradiated
ingredients) not to be declared. Labelling of GM foods has been
a continuous battle zone, with consistency only emerging when
civil disobedience forces retailers and the supply chain to imple-
ment traceability systems. Labelling, in short, is not a resolution
to the Food Wars but another battlefield within them. Yet poli-
ticians regularly cite labelling both as a principle of and a means
for consumer sovereignty.67
One of the major battles within the warzone of labelling has
been what can and cannot be said about the nutrient content of
 THE CONSUMER CULTURE WAR 203

foodstuffs. While the US has now introduced mandatory nutri-

tion labelling for most food products, in Europe such labelling is
still voluntary unless a particular health claim is made. Food
labelling and its effectiveness in consumer transactions are likely
to continue to be contentious for as long as some critics argue that
complex information on a label in tiny writing across dozens of
purchased goods does not enable the consumer to deliver for him
or herself a health-enhancing diet, and others argue that without
such information, the consumer remains in ignorance.
Whilst vast resources are now put into this area of policy, with
national and international meetings proliferating on all aspects
of labelling, we remain to be convinced that labelling is an
effective health strategy. Unfortunately, infringements of such
regulations as exist which involve intervention by food law
enforcement officers mean that labelling issues are likely to
remain a battlefield, set to become an even more hotly contested
area through the development of ‘health claims’ regulation which
will allow for disease-related labels on certain foodstuffs and
ingredients.

OBESITY: REDEFINING FOOD MARKETING

The obesity epidemic outlined in Chapter 2 will become a factor
in reshaping the future of food and beverages marketing through-
out industrialized countries. While the problem of obesity
has been often been classed as one of individual responsibility,
not least by the food industry, the rapid rise in obesity in low-,
middle- and rich-income countries is repositioning the problem
as a population one – with severe societal impacts. In the UK, for
example, the Chief Medical Officer described obesity in 2002 as
a ‘health time bomb’ bearing with it risks to the population’s
health, costs to health care services, and ‘disastrous’ losses to the
economy.68
But it has taken factors other than public health concerns
alone to focus the attention of the food industry on the true extent
of the obesity problem and force them to reassess their food and
beverage marketing practices. Instead, it has been the twin
threats of legal action against US fast-food restaurants in relation
to their products contributing to obesity in some individuals, and
204 FOOD WARS

dire warnings from financial analysts about slow economic

growth and weakened profit margins of some leading com-
panies, that has put the food industry on the defensive. In a truly
revealing piece of global equity research published by UBS
Warburg in 2002, the authors warned that the share prices of
many of the world’s biggest food companies are at risk because
of ‘consumers’ exposure to ‘unhealthy’ foodstuffs.69 They told
investors: ‘. . . we believe there are risks associated with obesity
that have not yet been factored into share prices.’
Further, an equity research report published by JP Morgan
in April 2003 predicted that food manufacturers faced risk of
increased regulation, notably in Europe, in labelling, advertising
and distribution of some of their key growth product areas.70
The authors described this as ‘not good news for volume growth
or margins’, and predicted long-term risks to producers of fast
foods, soft drinks, confectionery and snacks. As the Warburg
report put it: ‘Reducing obesity implies reducing calorie con-
sumption. If the [obesity] epidemic is to be tamed, the major
purveyors will have to see sales of many of their traditional
product lines fall.’
As part of the JP Morgan analysis, the authors drew up a list
of the product portfolios of those companies most exposed to the
‘obesity risk’ (based on percentage of total revenue), also predict-
ing growth opportunity for those companies focused on healthy
products and able to make the transition to ‘healthier’ options.
They singled out French company Danone as one such positive
example. Table 5.6 gives the figures.
The weak spot for the food industry in relation to obesity is
its marketing practices aimed at children.72 Indeed, trends in
childhood obesity are starting to appear frightening: prevalence
of the condition escalated in the US from 5 per cent in 1964 to 14
per cent in 1999; in the UK, in 2001, one in six 15-year-olds were
classified as obese; in Australia, one out of every five children is
overweight. Obesity-linked ‘adult onset’ diabetes mellitus is for
the first time being reported in children and adolescents in
countries like the UK.
In addition to this the public health voice is now speaking up
in ways that are unprecedented. For example, at the start of 2003
the World Health Organization went public about its concerns
that products like sugary drinks are contributing to obesity,
especially in children. The WHO urged governments to consider
 THE CONSUMER CULTURE WAR 205

Table 5.6 Leading food companies exposed to ‘obesity risk, 2003’71

Rank Company % of ‘not so % of ‘better

healthy’ food than’
1 Hershey 95% 5%

2 Cadbury 88% 12%

3 Coca-Cola 76% 24%

4 PepsiCo 73% 27%

5 Kraft 51% 49%

6 Kellogg 38% 62%

7 Wrigley 35% 65%

8 General Mills 35% 65%

9 HJ Heinz 32% 66%

10 Campbell 23% 77%

11 Unilever 23% 35%

(43% non-food)

12 Nestlé 22% 60%

(18% non-food)

13 Danone 20% 80%

clamping down on TV ads for ‘sugar-rich items’ to children. The

International Obesity Task Force in its September 2002 report
‘Obesity in Europe’ was unequivocal in its concern about child-
hood obesity, calling for a European Union-wide restriction on
advertising targeting the young, including pre-school children,
to consume inappropriate foods and drinks.
What is more, the idea of taxes on unhealthy foodstuffs is
again being openly discussed. For example, state legislators in
many US states have considered legislation to tax soda and
snack foods. Schools throughout the US are looking at the types
of product they stock in vending machines or sell on school
premises with the goal of reducing or banning sugary and fat-
laden products.
206 FOOD WARS

Campaign groups like the International Association of Con-

sumer Food Organizations (IACFO), an alliance of NGOs that
represents consumer interests in the areas of food safety, nutrition
and related matters, reports that the health of the children around
the world is put at risk by the marketing of junk food. In the
IACFO report, ‘Broadcasting Bad Health: Why food marketing
to children needs to be controlled’,73 it is calculated that:

l the food industry’s global advertising budget is $40 billion, a

figure greater than the Gross Domestic Product (GDP) of 70
per cent of the world’s nations;
l for every dollar spent by the WHO on preventing the diseases
caused by Western diets, more than $500 is spent by the food
industry promoting these diets;
l in industrialized countries, food advertising accounts for
around half of all advertising broadcast during children’s TV
viewing times. Three-quarters of such food advertisements
promote high-calorie, low-nutrient foods;
l for countries with transitional economies (such as in Eastern
Europe), typically 60 per cent of foreign direct investment in
food production is for sugar, confectionery and soft drinks;
for every $100 invested in fruit and vegetable production,
over US$1000 is being invested in soft drinks and con-
fectionery;
l over half the world’s population lives in less-industrialized
countries such as Russia, China and India and they are now
suffering a rising tide of diet-related diseases as food
companies export their products and their advertising
practices.

Research officer Kath Dalmeny, co-author of the report and a

member of the London-based Food Commission, part of the
IACFO alliance, continued: ‘Junk food advertisers know that
children are especially susceptible to marketing messages. They
target children as young as two years old with free toys, cartoon
characters, gimmicky packaging and interactive websites to
ensure that children pester their parents for the products.’ The
report calls for international controls on the marketing of high-
calorie, low-nutrient food to children. In particular, the IACFO
recommends that the WHO should:
 THE CONSUMER CULTURE WAR 207

l ensure children’s health protection is put before trade

concerns;
l support international controls on food marketing, including
cross-border television, websites and email marketing;
l coordinate a statement of responsibility outlining the rights
and responsibilities of food and beverage manufacturers and
advertisers; and
l monitor industry marketing practices and develop global
and regional targets.

In addition, a report by the UK Food Standards Agency in 2003

has prompted calls for a ban on advertising food to children and
for health warnings on snacks and sweets. The report singled out
what it called the ‘Big Five’ of bad children’s food – sugary
breakfast cereals, soft drinks, confectionery, savoury snacks and
fast foods – as indicating a direct link between the amount of
advertising seen by children and the food they eat.74
The food industry, in turn, has tried to respond to this on-
slaught on their food products and marketing practices with the
publication of a number of company and public policy state-
ments. One of the most high-profile early responses was from
Kraft Foods, announcing a new series of steps to strengthen the
alignment of its products and marketing practices with societal
needs. The Kraft strategy promises to focus on four key areas:
product nutrition, marketing practices, consumer information
and public advocacy and dialogue. To this end, Kraft has formed
a global council of advisers to structure a response to obesity and
to develop policies, standards, measures and timetables for its
implementation.75
Companies, such as Kraft and McDonald’s, aimed to be ahead
of many national health ministries in putting forward new policy
initiatives relating to the rapid rise in obesity and by taking such
initiatives to pre-empt regulation, taxes or other ‘burdens on
business’.

COOKING AND FOOD CULTURE

Television chefs are not a new phenomenon; they are as old
as television itself. Over the decades, TV cooking and food
208 FOOD WARS

programmes seemed to mushroom almost in inverse proportion

to the amount of cooking that actually occurred in the home, and
went mass, mainstream and practically daily. Books on cooking
and cuisine are currently in best-seller lists worldwide, and some
research has suggested that the greatest strength of the phenom-
enon is its entertainment value;76 in rich societies, actual cooking
is often now only an occasional or ‘hobby’ pastime rather than a
daily necessity. A 1997 European survey suggested that, although
the British public spent less time in the kitchen than their Euro-
pean neighbours, 42 per cent viewed cooking as an enjoyable
occupation, 14 per cent saw it as a creative activity and 11 per cent
used it as a ‘de-stressing activity’.77 A UK government-funded
study, however, found that, while some young people were
interested in learning to cook, they lacked actual skills.78
Cooking is a universal point at which the natural world meets
food culture.79 In this respect, the matrilineal thread to food
culture may be fraying: as family structures alter, mothers and
grandmothers are not the important purveyors of food culture –
teaching what to cook and how – they once were. In mobile and
media-dominated cultures, there are other means for transferring
food knowledge. Traditionally, and almost without exception
across cultures, cooking has been a predominantly female task,
but the skills base, in industrialized societies at least, is changing.
Young people, for instance, may not cook but they have different
skills from their predecessors.80 The question is: does it matter if
cooking is marginalized? In one corner are those who argue that
the arrival of pre-processed foods is a liberation for women
generally;81 in the other are those who argue that by not being
taught to cook, people lose a basic means for taking control of
their diet. People cannot be expected to control their diet as health
educators exhort them to do if they do not know what goes into
food; cooking is a life skill rather than a high moral pursuit. If
people do not know how to cook, they are entirely dependent
upon whatever others or the food industry provides for them.
Food culture then becomes a dependency culture – a far cry from
the rhetoric of consumer sovereignty.82
One in five Americans eats in a fast-food restaurant each
day;83 48 cents of every US dollar spent on eating in the US is
spent out of the home.84 Fast food is only one expression of the
American love of being on the move; the 150 million cars on the
roads by 2000 created a pressure for fast eating,85 which in turn
 THE CONSUMER CULTURE WAR 209

fed the US ‘long hours/few holidays’ work ethic and broke the
link with the cultures that immigrants brought from Europe.
Convenience is now also regularly cited in the EU as a key
influence on shifting food patterns. Yet, ironically, the concept of
‘convenience’ also implies leaving the responsibility for food
consumption choices to someone else – the food and beverage
processing industries. UK consumers, perhaps the most American-
ized of Europeans, are now adopting ‘grazing’ – constant snack-
ing – rather than eating at set times of the day.
Research on the British suggests their cooking patterns are
determined by structural factors such as longer working hours,
the increase in waged female work and longer shopping travel
times.86 Pre-prepared meals and better cleaning products mean
the average person spends 2 hours and 41 minutes less time
doing domestic chores per week.87 This is, however, balanced by
an increase in the time spent shopping and on associated travel-
ling to food suppliers, which has risen by two hours and 48
minutes per week, largely because of the growth of out-of-town
supermarkets.88, 89 In evolutionary terms, an entirely new food
culture is being induced. Mobility of course is not new; tradition-
ally almost all cultures have developed forms of wrapping food
either to preserve it or make it transportable. For example, the
ubiquitous sandwich – so named after an English earl, Lord
Sandwich,90 who in 1762 was so addicted to his gaming table that
he refused to leave it and stuffed meat between two slices of
bread in order to carry on gambling – is now a multi-billion dollar
industry across many countries.

SHOPPING, SPENDING AND FOOD

Although food is a basic need, it is only one of many spending
areas, and the food shopping culture is, like other shopping,
increasingly driven by the retail giants. Hypermarkets tend to
have a higher turnover per square metre of sales space than do
small shops, so that encouraging consumers to travel to a hyper-
market in pursuit of small cost savings is a very successful
marketing strategy. As a result, food shopping becomes a near-
identical experience everywhere in the world: aisles in bricks-
and-mortar-malls with car parks and open 24 hours; instead of
210 FOOD WARS

the consumer having at least eye contact with the retailer and
perhaps at best a chat with him, there is an alienated exchange
with a harassed, low-paid worker.
The net impact of this emerging shopping culture is external-
ized social and environmental costs: the bread or beans might be
cheaper at the hypermarket but the food travels further and the
consumer travels further to meet it. In the UK, it has been estim-
ated that half the food consumed by the country’s 60 million
mouths is sold from just 1000 stores,91 with village stores and
overall diversity threatened and with some communities
becoming ‘food deserts’, where there are no or few shops.92, 93
(And this in a land that, more than two hundred years ago, first
Adam Smith and then Napoleon famously called ‘a nation of
shopkeepers’!) The retail concentration trend is widespread
internationally, and within this food culture, it is often difficult
to see a place for a health culture.

FOOD ACTIVISM AND THE ROLE OF NGOS

A relatively new player shaping food culture and driving many
food trends has been food activism and, allied to this, NGOs
campaigning on behalf of food and health. In the 1980s and 1990s,
some extraordinarily creative and effective NGOs emerged in the
food policy world: in Brazil, for example, groups like IBASE
(Instituto Brasil rode Análises Sociais e Econômicas) in Rio and
the Global Forum on Sustainable Food and Nutritional Security
in Brasilia both lent their weight to the mass campaigns for the
right to eat and against hunger; in India, groups like the Delhi-
based Research Institute for Science, Technology and Ecology
worked with farmers on sustainable agriculture and in defence
of home-bred seeds, while consumer groups like the Jaipur-based
Consumer Union and Trust Societies (CUTS) worked on food
standards and globalization; and in Australia, the Australian
Consumers’ Association, a member of Consumers International,
worked on labelling, while the Eco Consumers Network linked
human and environmental health and the Landcare network
encouraged positive systems for protecting our fragile soils and
ecosphere. In Canada, too, the Toronto Food Policy Council
pioneered a new forum for stakeholders in the local food system,
 THE CONSUMER CULTURE WAR 211

while at a national level the Council of Canadians tackled govern-

mental sale of Canada’s ample water assets. In Malaysia, the
Consumers’ Association of Penang campaigned against pesti-
cides and for the quality of chicken feed, while the Third World
Network pushed back the boundaries of consumerism by being
the earliest to recognize the significance of the Uruguay Round
of GATT.94
All this activity laid the foundations for the demonstrations
in Seattle in December 1999, 95, 96 an unprecedented coming-
together of NGOs from all around the world. Unfortunately,
although there was strong representation from proponents of
environmental health, there was next to none from the public
health world.
In the UK, partly due to the vacuum in food governance in
the period of neo-liberal Conservatism from 1979–1997, NGOs
opened up new fronts and popular discourse on food and health
issues such as labelling, the introduction of new food techno-
logies, food safety and adulteration, food poverty, the morality
of marketing targeted at children and nutritional standards of
public food. NGOs throughout the world have been adept at
building not just national, but international coalitions and net-
works, and have become a powerful force behind food and health
concerns, but mostly as ‘single issues’ rather than as public health.
The core themes of this hybrid movement of food activism –
sometimes rather pompously referred to in UN or international
circles as ‘civil society’ – are beliefs that:97

l consumers have rights which must be fought for rather than

assumed;
l human and environmental health go hand in hand;
l there is no such thing as the average consumer and consump-
tion is socially fragmented;
l what matters is not just what is eaten, but how it is produced
and distributed;
l policies can be changed for the better but this requires
imagination, coalitions and focused effort.

A central tenet of these organizations, espoused also by the

academics who work with them and identify with them, is that
the ecological public health cannot improve or be protected
simply by exhortation and that health education is limited as an
212 FOOD WARS

effective policy strategy. 98 Due to their capacity to generate

publicity and to bear witness, NGOs have become powerful
voices within government and effective researchers into how
food is currently made, processed, distributed and marketed.
They are moving beyond the health education model that advises
people to take better care of themselves, arguing that individuals
are hampered in the marketplace by systematic biases and unequal
power. They lay down a challenge to business and governments
to reframe food governance and to set the rules of food engage-
ment in a way that biases health.
Formal reviews of consumerism suggest that consumer
NGOs tend to have limited industrial ‘muscle’.99 Consumer
boycotts – pioneered in the US against the British as early as
1764–1776100 – have had limited success; only when coupled with
mass political movements (as happened with Gandhi’s salt tax
boycott when leading his revolt against the British) do boycotts
have an industrial-style leverage. The international boycott of
Nestlé in the late 20th century for breaking of the UN code
against the marketing of breast-milk substitutes may have
been considered effective but it did not break the company: it
only embarrassed it and on occasions dented the share price.101
Instead, the greatest weapons that NGOs bring to the Food Wars
are their speed and flexibility, their ability to challenge carefully
crafted commercial images, a high level of public trust, inter-
national networks and media credibility, and quality and
independence in their research and policy proposals.
An opposing force to the growth of NGO influence has been
the number of global public relations companies and lobbyists
who have recruited teams to develop ‘dialogue’ with NGOs on
behalf of major corporate clients. An outcome of this activity has
been the emergence of counter-groups such as the fast-food
industry’s Center for Consumer Freedom, or the American
Council for Fitness and Nutrition, a coalition set up in 2002 by
leading food and beverage groups to counter charges that
suggest that the industry is answerable for the obesity problem
confronting the US population.
NGOs are now a clear and positive force in shaping food and
health culture, but, because they are neither governments nor
commerce, they lack ultimate power. The strengths of NGOs lie
in their abilities to build political pressure, to forge the links
between food supply chains and health, to integrate human and
 THE CONSUMER CULTURE WAR 213

environmental health, and to put these on the policy and political

agenda. Ultimately, however, only government can be a forum
for an integrated food and health policy.
In this chapter we have set out the notion of a ‘food culture’
in order to capture the diversity of influences within the food
economy that shape food consumption and the food consumer,
who in turn feeds new ideas and demands back into food supply.
It is within the dynamics of what we argue is a new food culture
emerging for the 21st century (as part of our paradigmatic shift)
that food policy-makers have to grapple with food governance
and reconciling the long-term needs of policy strategy with the
short-termism of much business, media and consumer activity.
The food culture challenge is heightened further by bringing the
health needs of individuals and populations within the sphere of
food policy. Not least is the challenge of linking both human and
environmental health demands as they apply to food. In the next
chapter we set out the scope of these environmental challenges.
214 FOOD WARS

CHAPTER 6
THE QUALITY WAR:
PUTTING PUBLIC AND
ENVIRONMENTAL
HEALTH TOGETHER
‘In an unequal agricultural society, with primitive techniques, where men
were at the mercy of nature and starved if the harvest failed; where plagues
and warfare made life uncertain; it was easy to see famines and epidemics
as punishments for human wickedness. As long as the level of technique
was too low to liberate men from nature, so long were they prepared to
accept their helplessness before a God who was as unpredictable as the
weather. Sin, like poverty and social inferiority, was inherited.’

Christopher Hill, historian, 1912–2003

CORE ARGUMENTS
Natural resources such as water, soil, land, plants and
biodiversity which underpin food consumption, have
been placed under growing strain by the modern food
economy, both by misuse of the land and by increasingly
wasteful systems of distribution. The inputs and outputs
of food production from chemicals to energy, are creating
major problems in their own right. Because human and
environmental health are so inextricably connected, solu-
tions for the future of food supply have to address environ-
mental quality and human health goals simultaneously.
Policy initiatives, while limited, collectively have awesome
implications for the redesign of the food supply chain and
for reframing consumer culture.
 THE QUALITY WAR 215

INTRODUCTION
This chapter turns to another war zone where the conflict between
how food is an environmental determinant of health and how the
environment determines or affects food is fought out. Food
quality is put into the front line: more than just cosmetic issues
such as appearance and colour, but hidden features such as toxins
or residues and the external implications of the food supply chain
(such as how much water is used and wasted in growing or
processing food and in transporting it).
Too many policy-makers still believe that they can merely
‘bolt on’ an environmental safety valve or eco-friendly niche
market to address the crisis of food and the environment. In any
other business but the food market, to despoil the natural capital
upon which one depended would be self-evidently folly and
managers would be disciplined or dismissed. Yet daily, poor
environmental decisions are taken in the name of so-called
efficiency to produce and distribute food. Food production
depends upon a sound and healthy environment in which
quality of input and output must be central. Food managers are
caught between the need dramatically to alter how food is pro-
duced and distributed – for instance, to slash energy use, ozone
depleters and waste – and their inability to do so because the
supply chain is so competitive and cost-cutting. In addition, for
example, eating fish products in the belief that ingesting fish oils
is beneficial for human health is ‘unproductive’ if landing or
farming the fish eventually destroys the very base of its own
production.
Market research into new product design or creation seldom
asks whether new food products are really needed in the first
place; instead, the economic assumption is that, if a product can
be made and sold, therefore it must fill a need. It is possible, for
example, to grow lettuce hydroponically – on water in green-
houses, fed by a judicious mix of basic nutrients, but it is not
viable to build the expensive greenhouses needed if lettuces can
be grown in season out of doors, or organically in the soil in the
open air, fertilized by composts that build the soil structure.
When food quality and environment quality are considered in
such a case, there are two health issues at stake: the first is the
actual health infrastructure of the food production system – its
216 FOOD WARS

soil, carrying capacity, ocean, access to water, and so on; the

second is the potential human health impact of inputs used
during production – such as pesticides, residues from drugs and
animal production, pollution and microbiological toxins. In this
chapter, we document both of these types of environmental
health impact, and we discuss in addition: biodiversity, the use
of water, soil degradation, climate change, urbanization, energy
use, food miles, fish and the seas, meat production and the use
of antibiotics, in order to underscore the intimate connection
between human and environmental health.
Consumers often say that they want to act more responsibly
towards the environment, yet they consume food that goes
against that principle; they say they are prepared to pay full costs
of production but they demand cheaper foods; the nature of
production in the food supply exercises them. As a result, issues
of food quality and their environmental links now demand
detailed management and more insightful policy. As food supply
chains have extended and become more integrated along their
links, the capacity for breakdown to spread rapidly through these
highly integrated logistic systems presents unprecedented dif-
ficulties for managers. A ‘buzz’ phrase in contemporary supply
chain management is ‘efficient consumer response’ (ECR), a
management belief that inefficiencies remain in long chains
unless all the management operate as one corporate whole, and
whose goal is to weed out weak links and inefficiencies in the
chain and to cut costs.
While ECR is being initiated throughout the Western food
supply chain, the consequences of its global reach are being
analysed by a group of social scientists meticulously mapping
the socio-geography of modern food supply chains, often by
studying particular commodities such as tomatoes, bananas and
tea.1, 2, 3, 4, 5 They reveal that, in the name of efficiency, social and
environmental degradation is often kept conveniently out of
sight of the Western consumer, but that damage happens none-
theless. In the Life Sciences Integrated paradigm, for instance,
there is a control ethic governing nature, plants, animals and
ultimately consumers; in the Ecologically Integrated paradigm,
the principles are more holistic: what matters are linkages rather
than mechanisms.
Environmental hazards facing the world extend beyond food
alone. Figure 6.1 gives a diagramatic representation from the
 Chemical hazards
Chemical hazards Water
Watersupply
supply
Sanitation
Pesticides
Pesticides Sanitation
& hygiene
&
Food safety
hygiene Food safety

Lead
Lead

Microbiological hazards
Microbiological hazards
Air
Airpollution
pollution

Arbo-
Arbo-
viruses
Occupational
Occupational viruses
andand
proto-
proto-
Noise
Noise environment zoans
zoans
environment Water
Waterresources
resources

F
EMF
Agricultural
Agricultural

EM
tion
rad.
Road
Road environments
environments Vector
Vector

ing rad.
traffic

radia
traffic
accidents

UV radiation
Ionising
accidents

Ioniz

UV
High
High risk
risk natural
natural
Physical
Physicalhazards
hazards
environments such
environments such
as
as wetlands
wetlands

G
G ee n
n ee rr aall eennvv ii rr o
o nn m
m ee nn tt
Risk factors
Risk factors:

Accidents
Accidents
Media
Media

Specific
Specificagents
agents

Source: WHO (2002) http://www.who.int/peh/burden/hurdenindex.htm

THE QUALITY WAR
217

Figure 6.1 WHO environmental hazards and risk factors

218 FOOD WARS

WHO of how food risks fit into this wider environmental context.
Note in this figure how the hazards that dominate contemporary
food policy – food safety and pesticides – while important are by
no means the whole picture. (Indeed, food safety’s contribution
to the alleviation of ill health is, as we noted in Chapter 2, very
small in the West but more important in the developing world,
largely due to poor water hygiene.) The new agenda of food and
public health has to be seen within this wider environmental
context.6, 7, 8 Public health could in the future be more appropri-
ately renamed ‘ecological public health’.9

CAN CONSUMERS SAVE THE PLANET?

In the light of ‘new’ environmental-protection factors such as the
limits to growth,10, 11 the cycle of pollution,12 and a holistic under-
standing of the earth’s life-support systems,13 a key question has
presented itself to public policy: what sort of lifestyle can the
planet sustain? To promote global human development as
though all can aspire to the lifestyle of the presently better-off
assumes wrongly not just that there are unlimited resources,14, 15
but also that there are no better ways of redistributing those that
exist.16 The UN Development Programme has calculated that it
is the richest 20 per cent of the world’s populations which already
accounts for:

l 86 per cent of all total private consumption;

l 58 per cent of the world’s energy;
l 45 per cent of all meat and fish;
l 84 per cent of all paper;
l 87 per cent of all cars;
l 74 per cent of all telephones.

Conversely, the poorest 20 per cent of the world consume 5 per

cent or less of all of the above goods and services.17
Proponents of maintaining current policies argue that such
statistics and claims fail to take account of human ingenuity or
that the poor are being denied the opportunities of the world’s
affluent. There is some validity in these positions but there is also
much evidence-based concern about the earth’s carrying capacity
and the unequal distribution of its output. We need to construct
a new ecological wealth for all nations.
 THE QUALITY WAR 219

To meet projected population growth and consumer demand,

global food production will need to double by 2020,18 and the
FAO is optimistic that food supplies can and will grow faster
than the world population. Even with 8 billion people by 2030,
‘ . . . more people [will have] an adequate access to food than in
earlier times . . . Growth in agriculture will continue to outstrip
world population growth of 1.2 per cent up to 2015 and 0.8 per
cent in the period to 2030.’19 This optimism, whilst welcome, is,
however, based on total food supplies and takes little account
of distribution or other ecological constraints. Food sits at the
apex of many biological givens: if good food requires clean
water, soil, air and healthy biodiversity, the purpose of any public
policy ought to be to nurture that interdependence of factors in a
virtuous rather than a vicious circle.

INTENSIFICATION
Intensification refers to the re-ordering of the food production
process to make it more capital and labour efficient.20 Under the
Productionist paradigm intensification had strong public health
proponents for the need to produce more food:21, 22 investment in
raising output would surely yield health, since under-production
and poor distribution were the key factors in food-related ill
health. On the land, there is an increasing reliance upon non-farm
inputs such as fertilizers and agrochemicals; labour is squeezed
to produce more per person and with fewer numbers, and made
more productive by the introduction of machinery and new farm
technology which replaces animal motive power. Such concen-
tration occurs at both an enterprise and a regional level: in the
dairy sector, for example, there has been a remarkable increase
in milk output from fewer farms, farmers, labourers and animals.
There is also an agricultural lean towards specialization and
standardization, which lead to monocropping and a decline in
the number of traditional mixed farms practising crop rotation.
Intensification has been the motor of 20th-century consumer-
ist prosperity in general and the increased output of agriculture
in particular, but it comes at an environmental cost: food is a
biological system, not the same as say, textiles or motor industrial
production, and intensification of foodstuffs can fundamentally
alter the nature of the final product. It affects, above all, the
220 FOOD WARS

nature of production and the dynamics of capital accumulation;23

it externalizes environmental costs. Pollution, waste and health
care costs can all be more fully costed by economists on the
‘balance sheet’ of food production.
There is also growing concern about the implications of
intensification on health in regard to pesticides, for example, and
their potential health risks to humans and the ecology,24, 25 as well
as potential hazards of chemicals in farming (which, research
now suggests, may be implicated in disrupting the endocrine
system).26
Intensification also means that, if there is a system break-
down, the ramifications spread quickly and extensively. In
January 1999 in Belgium, for example, two synthetic compounds
(PCBs and furans) were mixed with animal oils and fats by feed
processors and sold as animal feed,27, 28, 29 which travelled from
just ten feed makers to 1700 farmers and thence to millions of
poultry, pigs and cows. The resulting dioxin-contaminated feed
was the focus of a huge political scandal that toppled the govern-
ment and further dented European consumer confidence in
big farming.30, 31 The impact on Belgian food production was
immense, declining by 10 per cent in June 1999. The overall cost
to the Belgian economy was in excess of £750 million.31
Perhaps the greatest illustration of the health risks of the
intensification approach was the BSE crisis in the UK. Although
the official government report made it clear that in its view
intensification was not a cause,33 the intensification of the feed-
stuffs, dairy and meat processing sectors meant that it was almost
impossible to contain the outbreak easily. The freefall of public
confidence in national and European safety protection sent shock
waves throughout the continent and world and contributed to
strong pressure to reform the Common Agricultural Policy. The
BSE crisis’ resulting call to de-intensify agriculture weakened the
grip of the Productionist paradigm on policy-makers, and led
British and European policy-makers to increase support for the
greening of agriculture.34
One controversial argument is over whether the nutritional
composition of food is affected by the way it is produced and
how this effects the nutritional value of the diets of humans.
There is good evidence of the extraordinary changes in the
composition of meat and other animal products as a result of
intensification. A series of studies took as its base healthy relatives
 THE QUALITY WAR 221

of animals used in food production and observed their differences

from domesticated animals from the perspectives of intensive or
extensive rearing respectively. The study concluded that:

In the past it would have taken over six years for a steer to reach about
500kg body weight; with the feeding of high protein and energy feed it
takes less than 20 months to attain the same body weight. A 2kg broiler
is now produced in six to seven weeks instead of about 14 weeks.
Similarly, a dairy cow now produces about 9,000kg of milk a year as
compared to about 2,000kg about 40 years ago.35

Such meat, reared on a high-protein diet, has shifted from being

a ‘protein-rich’ to a ‘fat-rich’ food; the fat, in turn, is high in
saturated fats, and the weight gain in both beef and chicken is
partly due to the animal depositing excessive amounts of fat.
Wild species provide more than three times as much protein as
fat, compared to twice as much fat as protein in domesticated
animals. In addition the proportion of polyunsaturated to satur-
ated fatty acids is about 1:50 in domesticated animals compared
to around 1:23 in wild animals.36 We suspect that there will be
further interest in how intensification alters the composition
of foods, particularly in respect of micronutrients such as vita-
mins and minerals, and how the production process determines
their output and alters the food in unexpected ways. This was
dramatically illustrated by the surprise discovery by Swedish
researchers of high levels of acrylamide, a known mutagen, in a
range of ‘cooked’, processed foods including chips, breakfast
cereals and crispbreads. This led to an urgent WHO international
symposium, once other countries also found acrylamides
present.37 More important than changes due to the agricultural
processes might be health implications of what happens further
down supply chain. For example, in standard milling of white
flour, as much as 60 to 90 per cent of vitamins B6 and E, folate
and other nutrients are lost.38

FOOD AND BIODIVERSITY

According to the UN Environment Programme (UNEP), global
biodiversity is changing at an unprecedented rate, driven by a
combination of land conservation, climate change, pollution, un-
sustainable harvesting of natural resources and the introduction
222 FOOD WARS

of exotic species.39, 40, 41 Meanwhile, evidence from evolutionary

nutritionists is beginning to suggest that human physiology
requires a rethink of human nutritional needs in terms of its
diversity or variety of species consumed, not just their quantities
and proportion. Two leading researchers in this area have argued
that ‘because of an unusually large repertoire of essential nutri-
ents (macronutrients, micronutrients, vitamins and minerals, and
certain phytochemicals and zoo-chemicals whose essentiality is
yet to be defined), the human species is peculiarly destined to be
at once highly ecologically dependent and with a requirement
to locate various ecological niches for its survival.’42 In fact,
evidence for actual biodiversity loss is already considerable.
Current agricultural production is based upon crop strains, and
often uses an agricultural practice which, far from increasing bio-
diversity, is shrinking it.43 In the US, over 75 per cent of potato
production comes from four closely related varieties, 44 76 per
cent of snap beans from three strains, and 96 per cent of pea
production from just two pea varieties;45 95 per cent of cabbage,
91 per cent of field maize, 94 per cent of pea, and 81 per cent of
the tomato varieties have been lost; an estimated 80–90 per cent
of vegetable and fruit varieties, strong in the 19th century, were
lost by the end of the 20th century.46 Of the 10,000 wheat varieties
in use in China in 1949, only 1000 remained by the 1970s. In India,
farmers grew more than 30,000 traditional varieties of rice half a
century ago; now ten modern varieties account for more than 75
per cent of rice grown in that country.47 Often such ‘modern’
varieties of plants are grown for their weight, or volume, or
predictability, or responsiveness to fertilizers, with not enough
thought given to either the biodiversity or nutrition diversity.
Potatoes are another crop where the concentration of varieties
has accelerated. In the Peruvian highlands, a single farm may
grow 30 to 40 distinct varieties of potato, each having slightly
different optimal soil, water, light and temperature regimes which,
given time, a farmer can manage. Diversity like this requires skill.
By contrast, in The Netherlands, a different skill has been applied
to grow just one potato. One variety now covers 80 per cent of all
potato land.48
Overall, according to the FAO, around three-quarters of the
world’s agricultural diversity was lost in the 20th century,49 a
direct result of the pursuit of uniformity, control and predictability,
characteristics sought by businesses and processors. They want
 THE QUALITY WAR 223

routine, regular supplies. Fast-food firms want the same potato

worldwide. Together, agriculture and food culture are shrinking
biodiversity in the field.
This shrinkage has not gone unnoticed by some environ-
mental guardians, who are increasingly arguing that more effect-
ive national and international policies are required. The UNEP’s
‘Global Environment Outlook’ report underlines the case for
maintaining the health and status of biological entities on the
planet; we never know when we might need them, especially
since ten of the top 25 retail drugs in the world in 1997 were
derived from natural resources. There could be both health and
commercial advantages in retaining biodiversity. It is not just
plants that are narrowing in genetic source. More than 90 per cent
of all the commercially produced turkeys in the world now come
from three breeding flocks. The system is ripe for a new strain of
avian flu to evolve for which these birds have no resistance.50
Human activity including agriculture now threatens huge
numbers of species of fish, mammals and plants. The natural
world is said to be going through the sixth great period of
extinction of the last half billion years,51 and agriculture plays a
significant part in this tragedy by losing and degrading habitats;
it is also destroying pollinators whose presence enhances crop
yields. Animal grazing is also a significant threat to biodiversity,
as is drainage by destroying wetlands,52 and there are concerns
that precipitate use of biotechnology could release organisms
into the environment that are impossible to control or retrieve
and that will have their impact on biodiversity (as recognized in
the Convention on Biological Diversity).
In policy terms the choice is becoming clear. Agriculture and
food production can continue to degrade biodiversity or they can
be redesigned to enhance it. The viability of this latter policy
approach is already being made manifest by the sustainable
agriculture movement who are supporting, and learning from,
traditional farming methods as well as a wide variety of new
cropping techniques.53, 54 An International Treaty for Plant Genetic
Resources for Agriculture has been developed, but only 60
countries had signed by mid-2003, of which 30 had ratified the
treaty. It was due to come into force in 2004, once 40 countries had
ratified it.55 Such protection measures are painfully slow to
introduce as they threaten many interests, not least predators
seeking to exert intellectual property rights.
224 FOOD WARS

WATER
Water is critical not just for direct consumption and agriculture
but for hygiene.56 Water covers 70 per cent of the planet, but
97.5 per cent is ocean, not usable in industry, agriculture or as
drinking water. Of the 110,000 billion cubic metres of rainwater
that falls on earth, only 12,500 billion are accessible and usable,
yet this amount has been calculated to be sufficient for human
use. Water for domestic use (ie drinking) accounts for only 8 per
cent of the water available for human use, with agriculture using
70 per cent and industry 22 per cent.57 Modern agriculture is, just
like its consumer counterpart, a greedy consumer of water. The
demand for water is expected to grow in all regions of the world
over coming decades. A new water world order is emerging.
Countries like the US and Canada have vast water resources;
others such as Taiwan, Saudi Arabia and Germany are actually
in water deficit.58 The UNEP anticipates growing worldwide
‘water stress’ in coming years.59
Agriculture is both victim and perpetrator of our water
wastefulness, already accounting for 70 per cent of the freshwater
withdrawals in the world and acknowledged by the FAO as
mainly responsible for freshwater scarcity:60 lack of water in-
creases the chance of cropland being degraded; yet agriculture
is a major cause of this stress as it also pollutes drinking-water
quality in less developed countries which cannot afford the
filtration of contaminants.61 UK water companies have had to
spend £1 billion over a number of years to filter pesticide residues
out of drinking water to get it to meet tougher new standards,
illustrating how environmental costs can be externalized, and
only the application of a ‘polluter pays’ principle both puts a
monetary cost on this pollution and encourages re-internaliza-
tion of the cost. The water used by agriculture, drawn from lakes,
rivers and underground sources, is used mostly for irrigation
which helps provide 40 per cent of world food production62 (since
1961, the area of land being irrigated to increase yields by water-
ing crops has risen from 139 million hectares worldwide to over
260 millions).63 As a result, water tables are predicted to fall due
to over-irrigation and intensive crop production,64 and salination
to increase as a direct consequence.
Access to safe water is denied to 1.4 billion people, with 2.3
billion lacking adequate sanitation; an estimated 7 million die
 THE QUALITY WAR 225

each year due to water-borne diseases, including 2.2 million

children under 5 years of age. While in the 20th century, human
population tripled, water use grew by a factor of six,65 and by
2020 the availability of water for humans is expected to drop by
one-third. Water scarcity or stress – having less than 1700 cubic
metres of water per person per year – is estimated to affect 40 per
cent of humanity by 2050. The consequences are likely to be a rise
in food prices and health threats, and poor countries are likely to
be most heavily affected.66
Large-scale irrigation is probably reaching its limits. Projected
crop irrigation requirements by 2050, according to the World-
watch Institute, would require another 24 River Niles,67 even with
the use of better technology – using drips rather than constant
water spraying. It would now be sensible to invest in enhancing
the capacity of soil to retain moisture, which is a feature of
sustainable agriculture systems. Again, both on and off the land,
water security is set to become an even more serious issue.68, 69, 70

POLLUTION AND PESTICIDES

Over the last 30 years, since the publication Rachel Carson’s Silent
Spring, a study of the environmental impact of pesticides, 71
methods of food production have gradually become major public
and environmental health problems. Food is a vector by which
pollution can enter human bodies and create biological damage.
Table 6.1 summarizes how environmental factors can affect
health and gives figures on the health impact of food pollution.
Some of the food supply chain’s environmental pollution is
clearly related to intensification. A medium-sized US feedlot (a
mass cattle factory farm in the open air) can have an annual
throughput of 20,000 cows, producing as much sewage as a
town of 320,000 people73 and creating a serious problem with
waste disposal. (The Netherlands, as a small, intensively farmed
country, has critical problems in this respect and is having to
reduce its output of manure onto land.) Persistent organic pol-
lutants (POPs) – toxic synthetic compounds – accumulate in
the food chain, persist in the environment and travel by being
bioaccumulated (as animals eat each other, so the POP is stored
in fat and thus consumed and stored). Most humans have around
Table 6.1 Environmental factors affecting health72

Polluted air Poor sanitation Polluted water Polluted Unhealthy Global

226 FOOD WARS

and waste or poor water food housing environmental

disposal management change
Acute respiratory affections ü ü
Diarrhoeal diseases ü ü ü ü
Other infections ü ü ü ü
Malaria and other vector-borne ü ü ü ü
diseases
Injuries and poisonings ü ü ü ü ü
Mental health conditions ü
Cardiovascular diseases ü ü
Cancer ü ü ü
Chronic respiratory diseases ü
Source: UNEP (2000) Global Environment Outlook 2000, London: Earthscan, based on WHO data
 THE QUALITY WAR 227

500 POPs stored in their body fat that have been created since the
chemical revolution of the 1920s.74 Pesticides are a key route for
POPs, notably through aldrin, chlordane, DDT, dieldrin, endrin
and heptachlor. POPs have a malign impact on humans, wildlife,
land and water.
It is not unusual for daily US diets to contain food items
contaminated by between three and seven POPs. The main POP-
contaminated food items in the US have been found to be: butter,
cantaloupe melons, cucumbers/pickles, meatloaf, peanuts, pop-
corn, radishes, spinach, summer squash and winter squash,75 all
containing levels of POPs which may individually be within
safety limits, but which collectively pose a risk, according to
health standards set by the Center for Disease Control’s Agency
for Toxic Substances and Disease Registry and the Environmental
Protection Agency. Public health physicians argue that the only
health strategy is prevention,76 yet world pesticide usage grew
26-fold in the second half of the 20th century.77 In California,
the state which accounts for 25 per cent of all pesticides used in
the USA, toxic pesticide use on fruit and vegetables actually
increased between 1991 and 1995.
Although overall the quantity of pesticides applied in indus-
trial agriculture has declined recently, the toxicity of what is used
has increased by an estimated factor of 10- to 100-fold since 1975.
The pesticides are packing a heavier punch. Despite this, re-
sistance is spreading; POPs are becoming less effective: 1000
species of insects, plant diseases and weeds are now resistant, an
environmental impact known as the ‘treadmill effect’. However,
so extensive is the reach of POPs that even crops grown without
them may contain them, while crops grown using pesticides
contain much higher levels.78 And despite strong evidence of the
negative impact of POPs and their connection with pesticides,
governments only recently agreed the Stockholm Convention to
phase out their use. If governments want raised controls on
pollutants, such as from pesticides, regulations are essential,
although encouraging increased fruit and vegetable intake to
reduce rates of CHD and cancers tacitly encourages increased
intake of POPs through that route. However most epidemio-
logical evidence suggests that the relative risk of POPs is offset
by the gain from the nutrient intake of fruit and vegetables.79
From a policy point of view there need not be a trade-off of risks
and benefits; why should this be an either/or when it is possible
to aim for a win–win?
228 FOOD WARS

WASTE
One of the defining characteristics of modern food supply is
that, as the chain has lengthened, the packaging that comes out
at the end has increased. There is a strong correlation between
economic growth and growth of waste,80 and considerable cor-
relation with urbanization. The scale of the problem is significant.
In the EU, for example, waste generation per capita from house-
hold and commercial activities already exceeds, by 100kg, the
target of only 200kg per capita per year, set by the EU Fifth
Environmental Action Plan in 2001.81 Much of this waste goes into
landfill, creating more pollution and health hazards.
Whilst food always appears in most waste statistics, it is not
in fact the prime source of waste at the household level. In the
UK, for instance, of the 435 million tonnes of waste disposed of
each year, the household dustbin accounts for only 6 per cent of
the total, 8 per cent of which is sewage sludge; 36 per cent comes
from commerce and industry, and half is produced by primary
industries such as mining, dredging, quarrying and farming.82
However, mountains of consumer garbage is associated with
their food purchasing patterns – wrappers derived from a com-
bination of steel, aluminium, glass, textile, paper, plastic, poly-
styrene, cardboard and other fibrous forms. Six billion glass
containers are used annually in the UK, of which only 30 per cent
are recycled.83
Where some of this waste is re-usable (such as bottles which
can be both re-used and recycled), incidence of re-use is declining
in affluent Western societies. Some of the waste is in putrescible
form (ie compostable), and could be returned to refertilize the
soil. In 1999, the US Environmental Protection Agency estimated
that municipal solid waste consisted of 25.2 million tons of
foodwaste,84 of which containers and packaging were the largest
percentage by volume at 76 million tons or 33.1 per cent of
municipal product waste.
Much waste can only be recycled by industrial processes (the
fate of steel, aluminium and plastic), but thereby expending
double energy, first to be produced and then to be recycled. In
addition, much packaging that may be ideal for marketing or
microbiological safety is in fact unsuitable for recycling. Drink
cans, for instance, may have bodies of aluminium, tops and caps
 THE QUALITY WAR 229

of steel, linings of plastic and outers of paint or paper and even

another layer of ‘tamper-proof’ plastic, making their recycling
extremely difficult and energy-wasteful. And it is the local state
which carries the can, literally, for household and street waste;
even if waste-removal services are privatized, there will be a local
authority offering the contracts. It is for this reason that public
bodies are rethinking waste. They see an opportunity both to
clean the streets and protect the environment.85 In Canberra,
Australia, the authority now recovers 66 per cent of its waste and
Edmonton, Canada, achieves a target of 70 per cent.86
There is an incentive for the food industry to cut unnecessary
waste. In the UK, compared to 30 years ago, yoghurt pots are 60
per cent lighter. Compared to ten years ago, milk bottles are 30
per cent lighter, food cans 40 per cent lighter and drink cartons
16 per cent lighter.87 In Germany, since the introduction of tougher
recycling regulations in 1991, which put the responsibility on
manufacturers for their packaging waste and recycling, per
capita consumption of packaging has declined from 94.7kg in
1991 to 82kg by 1998. Tough regulations work.88

SOIL AND LAND

Barring a vast future investment in hydroponics, human food
production will always rely upon soil. Yet reviews of the status
of soil make sobering reading.89 Soil structure is being damaged
by desertification, pollution, water damage, clear-cutting of
forests and overgrazing, leading to loss of humus. Once lost, soil
is irreplaceable in the short term. The average loss of soil humus
in recent decades has been around 30 times more than the rate
throughout the ten millennia of settled agriculture.90 Demand for
animal protein has a knock-on effect on cropland and soil: if
consumer demand for meat continues to rise, pressure to crop the
land to feed animals will exploit the soil over and above the
pressure from population. Meat consumption drives a vicious
circle of energy and other fossil fuel inputs, chemicals, water and
protein as feed, let alone labour.
In Africa, for instance, more and more population-pressured
land has been taken into cultivation in response to commodity
prices. UNEP argues that much of the growth of production is
230 FOOD WARS

simply due to the use of new land. The paradox is that hunger
remains; and, by turns, there is land degradation as people search
for new sources.91 In addition, soil erosion encourages farmers to
use increasing amounts of fertilizers and agrochemicals, which
in turn threaten the health of the land. In the Asia–Pacific region,
an estimated 850 million hectares or 13 per cent of cultivatable
land is formally designated as ‘degraded’ due to a variety of
reasons ranging from salinity and poor nutrient balance to con-
tamination. ‘Desertification’ is spreading: in Western Europe, the
area of land being cultivated has fallen significantly for arable
and croplands and for pasturelands over the last 30 years. Water
damage from over-grazing and poor agricultural practices is
damaging European soils generally, and housing is seen as more
valuable than soil kept for food.

CLIMATE CHANGE
The Intergovernmental Panel on Climate Change recommends
a reduction of between 60 and 80 per cent of greenhouse gases
just in order to stabilize climate change, not even to reduce it;
the implications for health have also been mapped.92 World
energy use will grow by two-thirds between 2000 and 2030
despite its known impact on atmospheric and climate change.93
Its consequences (including flooding, temperature rise, volatility,
storms and spread of infection and parasites) hit the socially
marginalized and poor countries particularly hard because they
cannot buy their way out of such crises. But even more affluent
countries are affected by the spread of disease and crop failures:
the US is under siege from West Nile fever carried by mosquitoes,
and Europe is likely to be re-infected by malaria as temperatures
rise. Equally crucially key cash crops such as coffee and tea in
some of the major growing regions will, over coming decades, be
vulnerable to global warming.94, 95 The fear is that farmers will be
forced into the higher, cooler, mountainous areas, intensifying
pressure on sensitive forests and threatening wildlife and the
quality and quantity of water supplies. These crops, central to the
development agenda, not to mention the taste-buds of affluent
consumers, could fall by as much as a third,96, 97 and the impact
on the economies of the countries affected could be serious.
Agriculture earns Kenya an estimated $675 million a year in
 THE QUALITY WAR 231

exports, and of this, $515 million comes from tea and coffee
exports; for Uganda, annual agricultural exports are worth
around $434 million with tea and coffee worth $422 million. This
decline would coincide with the urgent need to raise yields to
feed a growing global population. Rising temperatures, linked
with emissions of greenhouse gases, can damage the ability of
vital crops such as rice, maize and wheat, to flower and set seed.
Researchers at the International Rice Research Institute (IRRI)
based in Manila in the Philippines estimate that average global
temperatures in the tropics could climb by as much as three
degrees centigrade by 2100. Their studies indicate that, for every
one-degree centigrade rise in areas such as the tropics, yields
could tumble by as much as 10 per cent. Such findings indicate
that large numbers of people, many already on low incomes, will
face acute food insecurity unless the world acts to address climate
change by reducing emissions of carbon dioxide and other green-
house gases. It is also why governments are beginning to take
climate change seriously. Even in the US, which has resisted
action on climate change, the Pentagon is now rightly concerned
about the military, political and food security implications of
climate change altering world food supplies.98 Continual energy
use – particularly oil – is driving environmental change.

URBAN DRIFT
People all over the world migrate to the cities to look for employ-
ment and better economic prospects; usually they yearn for
better access to amenities, services and food. 99 The result is
increased strain on the country to feed growing cities. Cities and
towns offer positive features such as access to education and
health care. Caloric intake tends to rise with urbanization, and
children can usually attain a better dietary status; but set against
these positive features is evidence of how urbanization also
brings the threat of marginalization: increased poverty, inequal-
ities, unemployment and dependency. Urbanization alters nutri-
tional status: intake of carbohydrates, meat, sugar and edible oils
increases; populations are more exposed to junk foods high in salt
and sugar and low in fibre; and intake of unprocessed foods
drops.
232 FOOD WARS

Yet against these worrying features, the range of diet can

actually improve in urban settings. Their populations have
greater economic pulling power and usually offer more diversity
of foods than are available in rural areas. In cities, the over-
whelming preponderance of food is purchased, although there is
a surprisingly high amount of urban agriculture ‘hidden’ in
urban areas. An estimated $500 millions’ worth of fruit and
vegetables is produced by urban farmers worldwide.100 Whilst
traditionally urban areas have been fed by their hinterland, this
is no longer the case in Western cities. Londoners, for instance,
consume 2 million tonnes of food annually, sourced from all over
the world,101 and the FAO estimates that in a city of 10 million
people, 6000 tonnes of food may need to be imported on a daily
basis.102
Between 1950 and 1990, the world’s towns and cities grew
twice as fast as rural areas. Many cities in the world already have
huge populations, such as Dhaka in Bangladesh with a popula-
tion of 9 million growing at an annual rate of 5 per cent, an
additional 1300 people per day.103 Other Asian cities are now
growing at a rate of 3 per cent per year, while African cities are
growing at a rate of 4 per cent per year. In the Phillipines, for
instance, 31 per cent of the population was urbanized in 1970; by
2001, 59 per cent lived in towns. Much of this growth occurred
following the opening up of the economy in the late 1990s. The
metropolitan area of Manila, which had a population of 200,000
in the early 1900s, grew rapidly to 9 million in 1999 and is set to
top 16 million by 2016.104 Even in a country such as Fiji, the
demographic transition has been rapid. In 1966, 33 per cent lived
in towns; by 1996 this had risen by half again to 46 per cent. Of
this urbanized population, 93 per cent lives in just five centres, a
concentration that is common in many countries.105 In China, the
number of cities with over 1 million inhabitants increased from
22 to 37 in just 12 years from 1985 to 1997. According to the UN
Population Division, China’s urban population will grow from
246 million in 1985 to an estimated 536 million by 2005 and 763
million by 2020.106
For the first time in human history, more than half of human-
ity is urban. In Latin America and the Caribbean, urbanization is
75 per cent; in Asia 38 per cent and in Africa 37 per cent.107 In 2025,
an estimated two out of three people in the world will live in
urban areas: fed by whom and on what? The World Bank has
estimated that there will be over 1 billion urban poor in the 21st
 THE QUALITY WAR 233

century.108 In 1950, the number of people living in cities was about

the same in industrialized and in developing countries – about
300 million.109 By 2000, some 2 billion people lived in cities in
developing countries, more than twice the number of urban
dwellers in industrialized countries. As populations in cities
expand, so does the demand for food to feed all the people who
are living there. Even allowing for urban food production –
gardens, smallholdings, even window boxes – the majority of
food in the city must be bought, and poor families often spend
as much as 60 per cent to 80 per cent of their income on food,
approximately a third more on food than their rural neighbours.
At its Habitat 2 conference in Turkey, the UN mapped out the
urgency of the task, concluding that urban or peri-urban agri-
culture will have to make a comeback.110 In Kathmandu, 37 per
cent of urban gardeners already grow all the vegetables they
consume, while in Hong Kong, 45 per cent of demand for veget-
ables is supplied from 5 to 6 per cent of the land mass. Across the
world, there is a burgeoning movement of local authorities, small
farmers and ecology-conscious consumers arguing for this
modern urban agriculture sector: ‘growing our own’. The WHO
Regional Office for Europe Nutrition Programme believes too
that local produce provides food security for otherwise marginal-
ized populations.111 This development is particularly urgent in
Eastern Europe where some catastrophic collapses in currencies
have been experienced; importing needs a strong currency.
Projects such as community gardens and city farms have already
sprung up in the industrial heartlands, showing that urban food
production has a social as well as economic value.112 Real market
economies can offer valuable encouragement to local production
to provide for more local need. If well planned, well located and
well organized, urban agriculture initiatives can be a strong
source of income for urban workers and help boost local
economies.113, 114 In Cuba, after the collapse of the Soviet Union,
ecological urban agriculture and gardens became a direct neces-
sity and has helped to feed and keep the population healthy,
much as it helps any population in time of war.

ENERGY AND EFFICIENCY

Consumers expect their food to be safe and to look good
but sometimes fail to recognize that the complex system of
234 FOOD WARS

distribution and production that keeps their supermarket shelves

so liberally stocked is in fact highly polluting. The UK food, drink
and tobacco sector emits 4.5 million tonnes of carbon annually
(compared to the chemical industry’s 7 million and the iron and
steel industry’s 10 million), and creates nearly 6 million tonnes
of waste, most of which is dumped in landfill sites.115
Environmental damage by food production is linked to
energy use required by types of packaging (see Table 6.2); by

Table 6.2 Energy used by product/packaging combinations for peas119

Steel Alum. Glass Multi-layer Frozen Fresh Fresh

can can one-way pouch carton carton imported
420 220 360 600
cm3 cm3 cm3 cm3

Total
energy
18.0 40.0 20.0 16.0 24.0 9.0 25.0
used in
MJ/kg

types of freight used (see Table 6.3); and by types of industry (see
Table 6.4). A typical British household of four people annually
emits 4.2 tonnes of carbon dioxide from their house, 4.4 tonnes
from their car, and 8 tonnes from the production, processing,

Table 6.3 Energy use and emissions for modes of freight transport120

Rail Water Road Air

Primary energy
consumption KJ/tonne-km 677 423 2890 15,839
Specific total emission
g/tonne-km
Carbon dioxide 41 30 207 1206
Hydrocarbons 0.06 0.04 0.3 2.0
VOC 0.08 0.1 1.1 3.0
Nitrogen oxides 0.2 0.4 3.6 5.5
Carbon monoxide 0.05 0.12 2.4 1.4
 THE QUALITY WAR 235

Table 6.4 Energy used per year by various UK food industries121

Energy use % of UK total

(10J) energy use
Direct fuel to agriculture 121
Fertilizers and agrochemicals 129
Machinery, manufacture and repair 51 6.2
Transport to and from farm 16
Imports of animal food 60
Food processing 527 6.0
Food distribution 451 5.0
Imports of human food 208 2.3
Home cooking 728
Waste disposal 26 8.5
Total 28.0

packaging and distribution of the food it eats.116 Travelling to and

from the food shops by car adds further environmental burden
and reduced physical activity, contributing to obesity. The large
rise in energy use on farms is illustrated in Table 6.5 which gives
the growth of energy use in the production of US maize over
time.117 Intensification, by reducing human labour, has placed the
energy focus on machinery and inputs. Between 1945 and 1985,
US maize production changed in its energy mix.118 For example,
labour was reduced fivefold while energy input from machinery
increased by a factor of 2.5. More strikingly, energy input from
fertilizers and irrigation increased 15- and 18-fold respectively,
yet over the 40-year period, the yield/ratio actually declined
from 3.4 to 2.9.
Table 6.6 shows the impact on both emissions and direct
energy use of different modes of transport used to freight food.
From a sustainability perspective, the optimum policy is to
consume food that is produced as locally as possible.

Food miles

The notion of ‘food miles’ has been developed for calculating the
distance that food travels between primary producer and end
consumer. Studies suggest that a major source of pollution from
the food supply chain is its increasing dependency on transport,
236 FOOD WARS

Table 6.5 Energy input in US maize production, 1945–1985, in

MJ/ha122

Activity Energy input

1945 1985
in MJ in % in MJ in %
Labour 130 1.2 25 0.1
Machinery 1701 16.3 4255 9.9
Draught animals 0 0 0 0
Fuel 5969 57.3 5342 12.4
Manure – – – –
Fertilizers 974 9.3 15,650 36.3
Lime 192 1.8 560 1.3
Seeds 673 6.5 2174 5.0
Insecticides 0 0 251 0.6
Herbicides 0 0 1463 3.4
Irrigation 522 5.0 9405 21.8
Drying 38 0.4 3177 7.4
Electricity 33 0.3 418 1.0
Transport 184 1.8 372 0.9
Total input 10,416 100 43,092 100
Yields 35,647 123,728
Yield/input 3.4 2.9

Table 6.6 Emissions and energy use by modes of freight transport123

Mode Description CO2 Emissions Energy consumption

(grammes CO2/ (MJ/tonne-kilometre)
tonne-kilometre)
Short-haul 1580 23.7
Air
Long-haul 570 8.5

Transit van 97 1.7

Road
Medium lorry 85 1.5
Large lorry 63 1.1

Roll-on/roll-off 40 0.55
Ship
Bulk carrier 10 0.15
 THE QUALITY WAR 237

both in transporting the food within the food system – from

farmer to depot to processor to retailer – and then to get the
consumer to the retailer.124 Some of this transportation appears
almost comical, with a classic study of a West German yoghurt
bought ‘locally’ using, in fact, ingredients – food and packaging
– assembled from hundreds or thousands of kilometres away.125
A US study of data on transport arriving at Chicago’s terminal
market from 1981–1999 found that produce arriving by truck
from within the continental US (ie excluding externally sourced
food) had risen from an average of 1245 miles to 1518 miles, a
22 per cent increase,126 with the national food-supply system
using 4 to 17 times more fuel than did the localized system.
An everyday meal is a minor piece of social history. Each
ingredient will have travelled some distance, probably be based
on a plant which has been grown thousands of miles from its
biological origins, and the foods will probably have been trucked
long distances. Table 6.7 disaggregates a meal eaten by one of the
authors in his home in London in the summer of 2001. This tells
a story of food miles that could be replicated throughout the
world.
According to the UK Department of Transport, despite approx-
imately the same tonnage of food being consumed annually
within the UK, over the last two decades the amount of food
being transported on roads has increased by 30 per cent;128 and
the average distance it has travelled has increased by nearly
60 per cent.129 Between 1989 and 1999 there was a 90 per cent
increase in agricultural and food products traded by road in the
UK.130 Worse still, total UK airfreight doubled over the same
period and is predicted to increase at 7.5 per cent each year until
2010.131 Not only is the same amount of food being transported
further, but British consumers are travelling further to get it, and
most often use cars to do so. The distance travelled for shopping
in general rose by 60 per cent between 1975–1976 and 1989–1991;
but the travel taken by car more than doubled.132 Far from hyper-
markets being ‘convenient’, they in fact generate more, not fewer,
trips for food shopping (UK Government figures also indicating
that the mileage of trips to town centre food shops is less than half
that of trips taken to edge-of-town stores),133 illustrating the
economic dimension of externalities: the price of modern foods
does not reflect the true price of food production.134, 135
Table 6.7 A simple dinner at home127

This meal for two was cooked at home and comprised:

l Pasta with herbs, dried tomatoes and olive oil

l Fruit salad with blackberry vinegar
l wine and water (LC), ginger beer and beer shandy (TL).

Food item Botanical Plant/cultural Grown/made in Bought in Food Distance

name of key origin miles from point
ingredient(s) (est) of purchase
DISH: PASTA
Pasta shells Triticum durum Egypt Italy Clapham 900 1 mile
Dried tomatoes Lycopersicon South America Italy Westminster 1000 3 miles
lycopersicum
Olive oil Olea europaea Eastern Italy Westminster 1000 3 miles
Mediterranean
Salt N/a Sea Sea (Maldon, Essex) Clapham 40 1 mile
Pepper Peper nigrum Malacor/ India Wandsworth 4700 ½ mile
Tranvancore Forests Common
Mint Menta spicata Uncertain origin Our garden N/a 0 0
Basil Ocimum basilicum India/SE Asia/NE Africa Our garden N/a 0 0
Food item Botanical Plant/cultural Grown/made in Bought in Food Distance
name of key origin miles from point
ingredient(s) (est) of purchase
DISH: FRUIT SALAD
Mulberry Morus nigra Central/Eastern China Thames Picked in a 3 3 miles
Embankment garden by the
Thames
Cherries Prunus avium Asia Minor/ US (Washington) Tooting 4600 1 mile
Mediterranean
Nectarine Amygdalus persica Uncertain (China) Italy Tooting 1000 1 mile
Peach Amygdalus persica China Italy Tooting 1000 1 mile
Blackberry Rubus ulmifolius Europe Our garden N/a 0 0
Melon Cucumis melo Middle East Spain Tooting 600 1 mile
Loganberry Rubus US Our garden N/a 0 0
loganobaccus
Blackberry Common/England Doncaster Clapham 170 1 mile
vinegar N/a
Table 6.7 (continued)
240 FOOD WARS

Food item Botanical Plant/cultural Grown/made in Bought in Food Distance

name of key origin miles from point
ingredient(s) (est) of purchase
DRINKS:
Beer Hordeum ditichon Barley – Near East; Wandsworth Wandsworth 2 miles ½ mile
+ Humulus lupulus Hops – Europe/W Asia (brewery) Common
Ginger beer Zingiber officinale Ginger – Asia Ginger from India, Wandsworth 4800 + ½ mile
+ Beta vulgaris Sugar – SE Asia sugar from East Common + 100
Anglia, brewed in + 200
Newcastle
Wine Vitis vinifera Shiraz (France) & Australia Wandsworth 10000 ½ mile
Cabernet Sauvignon Common
(France)
Water (bottled) aqua Aquifer France Wandsworth 450 ½ mile
Common
 THE QUALITY WAR 241

‘Ghost Acres’

‘Ghost acres’ was a notion developed by food analyst George

Borgstrom to refer to bought-in feedstuffs used in intensive
agriculture.136 (The term ‘ecological footprint’ is another term for
this use.)137 A study of The Netherlands, for example, found that
while the average human on the planet has 0.28 hectares of arable
land available to feed him or herself, a citizen in The Netherlands
actually uses 0.45 hectares of arable land.138 In other words, a
Dutch citizen is also reliant on ‘ghost acres’ outside of The
Netherlands to supply his or her food. Even the UK’s putatively
efficient food system sucks in the food products of other people’s
land and seas: especially the EU: soya, citrus, fishmeal, maize,
manioc and many crops are grown in and for Europe in huge
aggregate quantities, with the EU actually importing more fruit
and vegetables than it exports.139 One study has estimated the net
import of ‘hidden land’ into the UK was 4.1 million hectares in
1995,140 with much of the produce fed to animals, the fuel of
intensive husbandry. This form of global sourcing, however, is
not only energy-inefficient, but it is also doubtful whether it
improves global ‘equity’, and helps local farmers to meet the
goals of sustainable development.141
A study of London’s resource flow found that food was a key
source of the city’s consumption and environmental impact.142 Of
the 6.9 million tonnes of food consumed in London in 2000, 81
per cent was imported from outside the Greater London area.
Food accounted for 14 per cent of the city’s total consumption
(calculated as imports plus production, less exports) and for 2 per
cent of the waste, but in addition, 94 million litres of bottled water
were consumed in one year, creating an estimated 2260 tonnes
of plastic waste. Londoners use 6.63 hectares of earth space each,
with food accounting for 41 per cent of those ghost acres. For
London to become sustainable, its overall consumption needs to
reduce by 35 per cent by 2020 and by 80 per cent by 2050.
Like other so-called efficient food producing economies, the
UK’s population of farmers is declining143 and ageing. Because
people still have to eat, production is being drawn in from other
countries not always blessed with such a fertile and benign
climate as ours. Despite ideal conditions for top fruit production
(especially soft fruits and berries), for instance, nearly four out
of five pears consumed in the UK and two-thirds of its apples144
242 FOOD WARS

are now imported,145 imports coming from Chile, Australia, the

US and South Africa as well as from throughout the EU. The
policy question raised by the use of ghost acres in a rich growing
country like the UK is why it should be fed by others when it can
produce its own, has the land and climate to do so and when
others are perhaps more needy, both within their own popula-
tions and in neighbouring ones.
The world of sustainable agriculture is beginning to grapple
with the complexities raised by such environmental costs. The
image of ecological production may appear localist and ‘natural’
but the reality is not so simple; 70 per cent of organic produce sold
in the UK, for instance, is imported. The structure of the agri-
cultural market has hindered profitable production from meeting
consumer demand. If consumers want to be environmentally
benign, the solution is not necessarily to purchase organic pro-
duce:146 ‘local-ness’ of produce should be as important a factor as
the system of production, and for organic produce to warrant
high ecological favour, it ought be produced and consumed as
locally as possible. Long-distance organic food is not environ-
mentally benign, even if the demand for it sends ecologically
oriented signals to the supply chain. As can be seen from Table
6.8, locally produced food, even if produced intensively, can be
less environmentally damaging than organic food that has travel-
led intercontinentally.

EATING UP THE FISH?

Nowhere is the conflict between environmental and human
needs more apparent than over fish. While nutritionists advise
regular consumption of fish (particularly oily fish for its omega-
3 essential fatty acids), rising concern is expressed by marine
ecologists about the seas and fish farms reaching their ecological
limits. As with organic foods, the problems are not just about
production but also its environmental ‘friendliness’: the favoured
Spanish dish of baccalao (salt cod), for example, may have been
caught in the Baltic, but it lands in Norway and is processed
in Scotland before being served as a ‘Spanish’ meal. Fish also
strongly suggests the need for public policy to weave a sensible
mix between human health, ecology and culture.
Table 6.8 Weekly costs of food and drink in the UK (organic and non-organic)

Modes of production and Expenditure on External cost External cost Total external Real cost of Externalities
transport food and drink from farm from transport costs food (price + as % of price
(£ per person (£) (£) (£) externalities) paid by
per week) consumers
Conventional; local 16.94 1.563 0.004 1.57 18.51 9.3%
Conventional; national; road 16.94 1.563 0.096 1.66 18.60 9.8%
Conventional; national; rail and road 16.94 1.563 0.022 1.59 18.53 9.4%
Conventional; global–continental 16.94 1.563 1.190 2.75 19.69 16.3%
Organic; local 16.94 0.516 0.004 0.52 17.46 3.0%
Organic; national; road 16.94 0.516 0.096 0.61 17.55 3.6%
Organic; national; rail and road 16.94 0.516 0.022 0.54 17.48 3.1%
Organic; global–continental 16.94 0.516 1.190 1.71 18.65 10.1%
147
Source: Pretty, Hine et al (2001)
THE QUALITY WAR
243
244 FOOD WARS

One review of the fish situation has stated: ‘Major stresses are
evident in world food-producing systems, particularly land
degradation, declining freshwater stores, and fisheries deple-
tion.’148 The FAO now accepts that three-quarters of the world’s
seas are ‘maximally exploited’.149 The myth of seas as endless
sources of bounty is over, and independent reviews talk of
scarcity in crisis proportions.150 World fish catch (from the sea) has
never reached the 100 million tonnes dream anticipated by
policy-makers in the 1970s. While between 1985 and 2000, world
fish catch was stuck at between 80 and 90 million tonnes per
annum, by 1999, fisheries production had reached 125 million
tonnes, with 92 from sea (or capture) fishing and 33 million
tonnes from acquaculture; of these, 30 million tonnes were re-
duced to animal feed or oil. The rapid growth of aquaculture is a
new pressure on fish stocks, and some analysts are concerned
that rising demand for fishmeal (fish being caught wild to feed
to farmed fish)151 could place an even heavier pressure on fish
stocks. To add to the problem, an estimated 20 million tonnes of
fish harvested from the seas are discarded per year.
Poor people, in particular, are highly dependent on fish in
developing countries.152 Whereas supply to rich areas like the
North Americas rose by 27 per cent between 1978 and 1990 and
in Europe it rose by 23 per cent over the same period, supply to
Africa declined by 2.9 per cent and to South America by 7.9 per
cent. Regions vary considerably in their fish catch and culture.153
Measured as fish caught per person, West Asia has experienced
major drops in its fish catch since the 1970s, since the trend for
developing countries to turn to fish and fish products to build
exports. While the number of fishers, including fish farmers, has
grown to feed this trade, the FAO and the World Bank estimate
that 23 million Western Asians remain income-poor, (ie living on
less than $1 a day) working either as fishers or in related jobs.154
The salmon zones off North-west America have also shown
significant declines, with 24 sub-species on their danger list. In
North America and Europe, where intensive agricultural farming
is practised, run-off from fertilizers and manures into rivers and
seas has led to a phenomenon known as ‘nutrient-loading’. This
can mean that coastal fisheries are seriously affected by nitrogen
and phosphorus. One of the biggest recent ecological scandals
has been the pollution from intensive shrimp farming in Asia to
meet the West’s demand,155 and ancient coastal environments
 THE QUALITY WAR 245

such as mangrove swamps have been destroyed in subsidized

export strategies.156
Although the global fish catch (that is, sea catch plus aqua-
culture production) rose dramatically from 20 million tonnes in
1950 to 130 million tonnes in 2000,157 much of the growth from the
mid-1980s could be accounted for by China and much of that by
aquaculture, with the direct catch from inland and sea sources (ie
excluding aquaculture) reaching 94.8 million tonnes in 2000 and
was valued at $81 billion (see Figures 6.2 and 6.3). There is now
real evidence that the stocks are being depleted due to over-
fishing – enabled by technological advances such as ‘factory
fishing’ (huge trawlers indiscriminately vacuuming the seas for
fish) as well as wastage. The North American cod banks, for
instance, once proverbially rich, are now empty, and in Canada
in 1992, thousands of workers in Newfoundland and Labrador
were affected by a complete ban on cod fishing.158
The seriousness of the fish stock situation was emphasized
by the FAO in a 1999 submission to the WTO, a body designed to
facilitate trade, encapsulating over-fishing problem simply as
‘too many vessels or excessive harvesting power in a growing
number of fisheries’.159 Fleet sizes grew rapidly in the 1970s and
1980s worldwide and boats got larger, more ‘efficient’ and less

140

120

100

80 Capture
Aquaculture
60
Total
40

20

0
1996 1997 1998 1999 2000 2001

Source: State of the World’s Fisheries and Aquaculture 2002, FAO, Rome, Table 1, p4

Figure 6.2 World fisheries production, 1996–2001

246 FOOD WARS

Source: FAO (1997c) cited in UNEP (2000) Global Environment Outlook 2000

Figure 6.3 Global marine fish catch, by region, 1975–1995

discriminating about what they trawled. Fish are not only being
trawled out, but they are now also inadvertent concentrators of
contaminants like POPs, especially PCBs. Even inland, the US
Environmental Protection Agency has produced evidence of the
widespread chemical contamination of rivers and lakes by POPs
and, in 1999, PCBs were the single greatest risk cited in advice
notices to US fish consumers.160
In the UK, where most fish is consumed not as whole or fresh
fish but as fish products (such as the ‘fish finger’ in batter) despite
consistent health advice to consumers to consume more fish,
sales of both fish and fish products have steadily declined over
the last half-century (see Figure 6.4). Our nation surrounded by
sea is seeing an increased proportion of fish products imported
from seas far away, and shellfisheries in decline: an integrated
management designed to maintain shellfish production has
been lacking; instead there have been arbitrary standards set,
pollution from agriculture, inadequate powers being given to
local authorities and poor marketing. This mix has not been
helped by a decline in consumer demand.161 Meanwhile across
the English Channel, French shellfisheries thrive at the heart of a
tourist industry and are prized in the French cuisine, while in the
 THE QUALITY WAR 247
grams per person per week

250

200

150

100

50

0
0 4 8 2 6 0 4 8 2 6 0 4 8
195 195 195 196 196 197 197 197 198 198 199 199 199

Source: DEFRA (2002) National Food Survey, http://www.defra.gov.uk/esg/work_htm/

index/food.htm

Figure 6.4 Decline of UK household fish consumption, 1950–2000

UK, we have allowed a once-traditional and indigenous part of

our food culture to flounder.
While many national nutrition guidelines worldwide stress
the need for a significant intake of fish in the diet, now the
environmentally literate advice is beginning to be the almost
exact opposite.162 The seas are in such poor shape that they ought
to be protected in order to allow stocks to regenerate. Aqua-
culture accounts for much of recent decades’ uptake of fish
stocks, yet has an adverse environmental impact.163 Three to four
tonnes of marine fish, for example, can be used to produce one
tonne of farmed fish;164 Chinese aquaculture fishponds may yield
up to 35 million tonnes of fish a year, but they are beset by
infections and pollution; much aquaculture suffers from high
stocking density, poor water quality, eutrophication and pol-
lutants.165 New investment in skills and facilities, and ecological
controls on aquaculture are urgently needed. Aquaculture may
rightly become a source of growth and supply of fish for the
future, but not at any cost.
Fisheries policy is seriously under-discussed in food policy,
compared to agricultural policy. In the European Union, for
example, there are very few environmental or public health
lobbyists on the side of the Common Fisheries Policy, but there
are legions who pressurize decision-making on the Common
Agricultural Policy. The corporate sector, including such com-
panies as Unilever, has begun to take a lead, but its overall impact
so far is slight and what remains to be done is enormous.
248 FOOD WARS

MEAT
Intensification of meat production is coming under increasing
criticism for its adverse environmental impacts. Despite its social
and cultural importance, meat is notoriously inefficient as a
converter of energy. Vast quantities of grains are produced to feed
animals. It takes 7kg of feed to produce 1kg of feedlot-produced
meat, 2kg to produce 1kg of poultry meat and 4kg to produce 1kg
of pig meat.166 In addition, according to the International Food
Policy Research Institute (the IFPRI), per capita demand for beef,
poultry and pigmeat in China, for instance, is set to double by
2020, and the US grain trade is keen to exploit this anticipated
increase in Chinese demand as Chinese incomes rise. Ecologic-
ally, of course, it makes bad sense to use oil to transport heavy
grain to feed to animals the other side of the world and meeting
the aspiration for meat as prosperity rises needs to be seen
against the environmental impacts of using land for cattle rearing
and grain production to feed them.167
A curtailment of feeding animals in rich countries would not
automatically be translated into improved diets for the poor in
developing countries. IFPRI has calculated that a dramatic fall in
meat consumption by 50 per cent, for example, would only
deliver approximately 1 or 2 per cent decline in child malnourish-
ment.168 It warns against oversimple solutions, such as mass
vegetarianism, although there is good evidence that the vege-
tarian diet can be entirely satisfactory for health.169
This ‘meat or plants?’ debate illustrates a lifestyle conundrum
in relation to environmental versus human health goals. Just
as importantly, if an increase in the consumption of animal-
based foods contributes to the incidence of diet-related diseases,
surely an increase in meat and dairy production should not be
encouraged.

ANTIBIOTICS
Intensive agriculture such as meat production would not have
taken its current form without a whole panoply of veterinary
inputs and support. In this respect, the widespread use of drugs
such as antibiotics had knock-on health and environmental
 THE QUALITY WAR 249

effects: antibiotic resistance is building up in both humans and

animals, making it difficult to cure new infectious diseases, and
making new antibiotics both more elusive and more expensive.
‘Wonder drugs’ have generated ‘super-bugs’,170 and in the US,
for instance, antimicrobials are typically purchased and used
without a veterinary prescription.171 Pathogens thrive, according
to Professor Tony McMichael, an epidemiologist, because the
globalization of economic activities and culture, the escalation of
travel and trade, and our increasing use of intensified food
production and processing, other technologies, antibiotics, and
various medical procedures are all reshaping the world of micro-
bial relations. Pathogens live today in a world of changing,
mostly increasing, opportunity.172
In 20 years, some forms of Salmonella have developed multiple
drug resistance, the number increasing from 5 per cent to 95 per
cent today. Methicillen-resistant staphylococcus aureus (MRSA) has
grown from 2 per cent to 40 per cent in just one decade.173
The US General Accounting Office first raised its concerns
about the cost to human health of excessive use of antibiotics in
intensive animal rearing in 1977.174 Two decades later, the US
Federal bodies had still failed to produce an integrated health
policy.175 In fact, the situation is now alarming. The effectiveness
of antibiotics which have saved tens of millions of lives in the last
half century is being radically undermined by a number of
features:

l excessive prescription by doctors;

l poor use by patients (eg not completing a course of treatment);
l routine use of antibiotics as growth promoters in intensive
animal husbandry and in veterinary practice;
l the capacity of bacteria to adapt and produce new antibiotic-
resistant strains.

There is now an ample scientific evidence for the gradual erosion

of the effectiveness of antibiotics.176, 177 Antibiotic-resistant tuber-
culosis, for instance, rose in New York from 1–2 per cent of cases
in 1950 to over 30 per cent in the 1990s.178 In 1998, the UK House
of Lords Committee on Science and Technology concluded that
imprudent use of antibacterial drugs had made many new drugs
worthless;179 it concluded that the only way to foster their effect-
iveness is to restrict their use. A 1997 WHO conference also
250 FOOD WARS

recommended the termination of the use of antibiotics as growth

promoters in farm animals if they are also used for human
health.180
In 1986, Sweden banned the use of growth promoters; the UK
had banned the use of penicillin and tetracycline for growth
promotion as early as the 1970s; Denmark banned virginiamycin
in January 1998 and reduced its use of antimicrobials in food by
54 per cent by 2001. This caused a loss, it has to be said of €1.04
per pig; but there were no economic losses for poultry. The entire
strategy was judged a success when the World Health Organiza-
tion conducted a review in 2002.181 Canada has called for volun-
tary reduction. This piecemeal situation will probably change
gradually, following the EU’s ban on the use of four antibiotics
as growth promoters – bacitracin zinc, spramycin, virginiamycin
and tylosin phosphate – which took effect in 1999.
Antibiotics are central to the production of cheap meat. It is
estimated, for example, that 70 per cent of all antibiotics in the
US are used on healthy pigs, poultry and beef cattle.182 With
controls on antibiotic use and other animal welfare protection
strategies being enacted into law, particularly in the EU, there
appears to be a geographical relocation of poultry production to
areas of the world where land and labour are so cheap, and
regulation and inspection less than tough.183
There is a growing conviction among medical and veterin-
ary science, as well as amongst some food producers, that this
situation is unacceptable. In 2002, a US review commended the
prudent use of antibiotics and stressed ecological as well as the
human-health implications, warning that resistant bacteria can
outcompete, and propagate faster than, non-resistant bacteria.184
Similarly, the European Commission has proposed the phas-
ing out of antibiotics used as growth-promoting feed additives
(with some coccidiostat exceptions) by 2006. Some larger com-
panies have pre-empted this and already taken unilateral action:
McDonald’s decided in 2003, for instance, to curtail its use of
meat from livestock treated with antibiotics.185

KEEP EATING THE FRUIT: A UK CASE STUDY

Health education advice is for the population to eat lots of fruit
and vegetables: they are rich in vitamins and other micronutrients
 THE QUALITY WAR 251

that help prevent some of the degenerative diseases we reviewed

in Chapter 2; in particular, there is strong evidence for their
protective effect against chronic diseases such as CHD and
cancer.186 Since 1990, the WHO has recommended that people
should eat at least 400g (approximately 5 portions) of fruit and
vegetables per day,187 which could reduce overall deaths from
such diseases by up to 20 per cent.188 This is a positive message
forming the core of much health education and policy. But in a
country such as the UK, the production of fruit and vegetables is
declining and the deficit is made up by huge increases in imports.
According to national agricultural statistics, over the period
1989/91 to 2000, the UK area given over to fruit production
declined from 46,700 hectares to 34,200 hectares (see Figure 6.5),189
and total production in this period declined from 527,000 tonnes
in 1989/91 to 305,000 tonnes in 2000, although imports shot up.
The result has been a large deficit in the national food trade gap
which has grown by value over recent decades.
Nonetheless, while the UK has experienced a long-term decline
in per capita consumption of fresh vegetables, there has been an
increase in consumption of fresh fruit: often in processed form,
either pre-cooked or as juice, but also as fresh produce which still
accounts for 61.6 per cent of all fruit and vegetable sales.190
From a nutritional perspective, progress is painfully slow, but
over time and overall the UK population is very gradually in-
creasing its intake of fruit and vegetables. At this rate, according
to researchers at Oxford University, the British will meet the
WHO guideline of consuming 400g per person per day only by
2047 (Figure 6.6).191
At present levels, UK consumers consume less fresh fruit
per head than many of their European counterparts. British
children – particularly those growing up in poverty – are eating
considerably less than the recommended five portions of fruit
and vegetables a day; consumption of fruit and vegetables by
children fell over the last 20 years of the 20th century.192
In fact, fewer than 20 per cent of 2 to 15-year-olds eat fruit and
vegetables more than once per day and the typical diet of chil-
dren and adolescents is rich in fat, sugar and salt.
A study of 2635 schoolchildren aged 11–16 years in schools in
England and Wales in 2001 found that on average they consumed
only one-third of the recommended 35 portions of fruit and
vegetables per week. Five per cent of the sample reported that
252 FOOD WARS

200
185.3
180
160 155.9
152.7 149.1
140 145.1
137.0
hectares
es

120
’000 hectar

100
80
60
40
20
0
Average of 1997 1998 1999 2000 2001
1990–92 (provisional)

Source: DEFRA/Scottish Executive Environment and Rural Affairs Department/

Department of Agriculture and Rural Development (Northern Ireland)/National
Assembly for Wales Agriculture Department (2001) Agriculture in the United Kingdom,
p42

Figure 6.5 UK production area of fruit and vegetables, 1990–2001

they had eaten no vegetables at all in the previous seven days,

and 6 per cent reported eating no fruit at all in that period.193 The
study confirmed theories that lower-income households con-
sume less fruit and vegetables, but proportionately more sweet
foods, soft drinks, crisps and chips than their richer counterparts.
Health education must be speedily implemented to alter such
figures for the better.
The irony of this picture from a business perspective is that
fresh produce has become one of the most value-added sectors
within food retailing, with supermarkets in the UK making good
profits from sales of fruit and vegetables proportionate to their
shelf space. In the US, the 20th century saw a decline in the state-
based sourcing of fruit and its replacement by a concentration of
production in California and to a lesser extent in Florida;194 at the
same time, there was a search for all-year-round fruit: instead of
capitalizing on the seasons, traders and retailers, of strawberries
for instance, pursued locations which offered compliant labour,
land and national regulatory regimes.195
 3500

3000

2500

2000

1500

g/person/week
1000

500

0
75 78 81 84 87 90 93 96 99 02 05 08 11 14 17 20 23 26 29 32 35 38 41 44 47 50
Year

Source: Mike Rayner calculations based on MAFF (2001) National Food Survey 2000, The Stationery Office, London
THE QUALITY WAR
253

Figure 6.6 UK fruit and vegetable consumption, 1975–2000, with COMA targets to 2045
254 FOOD WARS

THE CLASH OF FARMING AND BIOLOGY: HAVE

HUMANS GOT THE WRONG BODIES?
An examination of the relationship between environmental and
human health raises an important question as to how the well-
being and disease patterns of humans are related to the environ-
ment in which they find themselves. The new science of eco-
nutrition and our greater understanding of biological systems
suggest a close and symbiotic relationship between the two,
while, in the period of the Productionist paradigm, there has been
a disastrous disconnection of production, ecology and human
health.196 The future lies in re-creating the connections and in
developing policies, business solutions and a food culture that
respect these connections.
The recognition that diet and health are connected has moved
human biology centre-stage in the war of paradigms. What are
humans biologically programmed to require, thrive on and get
ill from? Could genetic screening find out which genotypes are
disposed to particular diseases? Within the Life Sciences
Integrated paradigm, the response to these questions is clear: if
modern lifestyles are not burning up enough of our energy in the
form of food, and if we decline to eat less because food is pleasure
and because culture is built around it, then food must be altered
to fit our new circumstances. In other words, the problem is not
the diet but human biology, and a whole new way of conceiving
both public policy and food supply chains opens up. Suddenly,
commercial and state policy can focus responsibility for diet and
health care onto the consumer, and this position – that there is
nothing wrong with the food; the problems are all in the genes –
is the sophisticated health spin powering the future of much food
and health policy.
According to palaeontologists, the earliest experimentation
with systems of agriculture only became possible once settled,
rather than hunter–gathering, societal forms emerged during the
so-called ‘Neolithic Farming Revolution’, eight and ten millennia
ago. Whether the Neolithic change to agriculture from hunter-
gathering was as clean or clear cut as has been traditionally
thought is now the subject of some argument among researchers
into the origins of the species.197 As settled agriculture spread,
and particularly as new seeds and then domestic animals were
 THE QUALITY WAR 255

developed, a new civilization became possible: people could live

in a different way; diet could become a matter of choice of culture
– literally agriculture, cultivation of the land – or plantation
rather than subject to necessity or availability.198
Agriculture enabled Homo sapiens eventually to prosper.
People were now able to eat a diet different from the one for
which human evolution had prepared them: culture, as well as
raw necessity and biological predispositions and determinants,
began to shape diet. As Professor Michael Crawford puts it, the
foods humans ‘ate throughout 99.8 per cent of [their] history and
those [they] eat today are different in many ways’.199 Agriculture
pressed back wild culture. Crawford again: ‘Up to the invention
of agriculture, the species that was destined to be wildly success-
ful, perform brilliantly (in evolutionary terms) and to dominate
all living things [ie humans], lived on food that was wild.’200 And
this enabled a new eating experience. The Neolithic Revolution
domesticated animals and plants but also humans.
Some ecologists are now questioning whether this ‘human-
ization’ of progress threatens the planet’s capacity to carry
civilization itself, let alone whether it can be healthy.201, 202, 203
The ‘deep ecology’ position claims that the notion of progress
associated with Western or Anglo-Saxon capitalism as the solu-
tion for a better life is hindered by technology. This view rejects
the argument that commerce needs to be and can be humanized
to get it back on the right track,204 while others argue that this
same insight should send urgent signals to commerce, including
in particular the food industry, to cut energy use, reduce waste
and change production methods, for instance by reintroducing
biodiversity into farming and thence to diets.205
The environmentally friendly rule for the 21st century prob-
ably ought to be to eat a diet that is both local and that maximizes
biodiversity. But to be able to eat a variety of foods, soundly pro-
duced, is ‘contingent on biodiversity’ according to Professors
Wahlquvist and Specht, two Australians who have taken a special
interest in the relationship between ecology, biology and nutri-
tion, asserting that, ‘with a week as a time frame, at least 20, and
probably as many as 30 biologically distinct types of food, with
the emphasis on plant food, are required’.206 There are a number
of potential far-reaching implications for food supply and farm-
ing in particular from this sort of perspective. Biodiversity needs
to be on the consumer’s plate, routinely.
256 FOOD WARS

There is a current vibrant debate raging about the appro-

priateness of an evolutionary perspective on diet and health.207
An eco-epidemiology paradigm has been proposed to examine
individuals and how they connect with their context.208 Some
argue that policy needs better to understand the Paeleolithic
origins of human biology and food preferences,209 while others
argue that it is difficult to apply any historical suppositions into
a modern time frame.210 The core argument is whether humans
have evolved to eat certain foods, and whether our present
physiology is determined by our evolutionary past; the policy
question is whether today’s agriculture can provide us with
foods that we need physiologically and socio-psychologically as
befits our evolutionary past.
Throughout this chapter, the understanding mapped on the
diet–health–environment connection suggests the need for a
radically more integrated approach to public health. Too often,
one has the feeling that while the proponents of the Life Sciences
Integrated paradigm are planning the future of the food supply,
the ecologists are bemoaning its present, and public health is
studying the past. Counting bodies as they fall off the cliff may
be good epidemiology but it is poor public policy. In the next
chapter we argue that a new ecological public health movement
needs to learn stringent lessons about structures and policy, the
current lack of which goes to the heart of the paradigm wars.
 FOOD DEMOCRACY OR FOOD CONTROL? 257

CHAPTER 7
FOOD DEMOCRACY OR
FOOD CONTROL?
‘A day will come when the only fields of battle will be markets opening
up to trade and minds opening up to ideas. A day will come when the
bullets and the bombs will be replaced by votes, by the universal suffrage
of the peoples.’

Victor Hugo (1802–1885) in a speech to the Congrès des

amis de la paix universelle, Paris, 22 August 1849

CORE ARGUMENTS
Many institutions of food governance are out of date and
struggling to maintain consumer trust. They also have
failed fully to address the changing nature of the food
economy and the challenges raised by public health on the
one hand, and by corporate influence on the other hand.
Institutions need to rethink the relationship of the global
to the local, while rebuilding public trust by engaging with
social concerns. Food and health policy needs to be a
central concern for the state since it is our sole mediator
between increasingly powerful interests and the con-
sumer. All too often, the institutions of food governance
fail to integrate food with health; the many existing policy
commitments to which governments lend their name are
not being actively enough pursued; state support for
Productionism is now out of date. A central tension for the
future of food governance will be negotiating the (im)-
balance between ‘food democracy’ and ‘food control’: food
policy can only be legitimized if created through a process
that is democratic rather than ‘top-down’. Leadership will
be needed to achieve a new vision for food governance.
258 FOOD WARS

WHY IS GOVERNANCE AN ISSUE?

In this chapter we argue that there is a crisis of institutions and
of governance – that curious English word that refers to the
science and practice of government – over what to do about food
and health. Governance, according to Richards and Smith, ‘is
generally a descriptive label that is used to highlight the chang-
ing nature of the policy process in recent decades. In particular,
it sensitizes us to the ever-increasing variety of terrain and actors
involved in the making of public policy. Thus, governance de-
mands that we consider all the actors and locations beyond the
“core executive” involved in the policy-making process.’1 This
chapter sets out to detail the wider terrain and actors involved
in food governance, not least where the ‘push’ and ‘pull’ of food
policy-making is located. In this respect we argue that there
needs to be more room for what we call ‘food democracy’ within
the more centralized food governance environment currently in
place.2
One of the major battles in terms of governance, from our
point of view, is to get health, in an integrated sense, taken more
seriously in the institutions of food governance. Too often in local,
national, regional and global institutions, while many divergent
views proliferate, they fail to integrate food and health. Today,
more than at any time in human history, institutions central to
food and health governance are multi-level: they can be placed
in at least five levels of governance, from the global to the com-
munity (see Table 7.1). There is tension between these levels, with
political debate raging about whether power is sliding up to the
global institutions, whether more local institutions have lost their
power and influence, or whether the global bodies are ultimately
having to bow down to national and more accountable local
levels.
The tussle between globalization and localization, then, is
being fought out in food and health. Food enforcement has to
happen locally, yet legislation is increasingly being set, not at
national but at international level; through such bodies as the
European Union, the Asia-Pacific Economic Cooperation or the
North American Free Trade Agreement, and with the creation of
newer bodies such as the WTO.
At the global level, there are many bodies which have either
a pre-eminent role in relation to national ministries and agencies
 FOOD DEMOCRACY OR FOOD CONTROL? 259

Table 7.1 Multi-level governance in relation to food and health

Level of Example of Food and health role

governance institutions
Global UN, WTO, Intergovernmental
Codex Alimentarius negotiations; coordination
Commission of expert consultations;
setting and sharing policy
agenda and standards

Regional North American Free Set trade rules between

Trade Agreement, Member States; develop
European Union, ASEAN regulation; cross-border food
safety issues

National 200+ nation states Legislation and regulation;

health care, policy covering
food supply chain; dietary
guidelines

Sub-national Regional health bodies, Coordination of local

elected regional initiatives; regional voice and
assemblies policy

Local/community Town or village council; Delivery of local services

health authorities; such as food law
community centres enforcement, primary health
care, dietetic advice

or which have a coordinating role; others such as the World Bank,

the WTO, and UN bodies such as the WHO act as initiators and
think-tanks for global food and health approaches and they have
considerable influence on the panoply of national government as
well as in the subtle framing of the food supply chain within and
between nation states.3 Table 7.2 lists some examples of these
institutions.
Such institutions frame and tussle over existing policy
commitments; their role is significant, both in why the state has
supported Productionism and why the costs can no longer be
borne. A constant theme of debates about governance is re-
sponsibility and control over the food supply chain. The creation
of mechanisms for an integrated government overview of food
policy is now urgently required. There is an immense body of
260 FOOD WARS

Table 7.2 Global institutions involved in food and health

Remit Examples of organizations/bodies

Public health WHO, FAO

Children and health UNICEF, UNESCO

Global economic bodies World Bank, International Monetary Fund, UN

with health impact Conference on Trade and Development
(UNCTAD), WTO, World Intellectual Property
Organization (WIPO), Organisation for
Economic Co-operation and Development
(OECD)

Intergovernmental Bio-safety Convention, International

agreements with a Conference on Nutrition, Basel Convention on
health impact Hazardous Waste

Emergency aid World Food Programme, International

Committee of the Red Cross/Crescent

Environmental health Global Panel on Climate Change, UN

Conference on Environment and Development
(UNCED), International Maritime Organization

Commercial interests International Chamber of Commerce,

transnational corporations, International
Federation of Pharmaceutical Manufacturers
Associations

Regional bodies with European Union, Regional Offices of the WHO

health role and FAO

Trade associations International Hospitals Federation

Networks to promote Healthy Cities Network (WHO), International

public health Baby Food Action Network (IBFAN), Local
Agenda 21 Network, Pesticides Action
Network, Tobacco Free Initiative (WHO)

Professional associations International Union of Health Education

Non-governmental Greenpeace, Friends of the Earth, Oxfam,

organizations Médecins sans Frontières, Médecins du
Monde, World Federation of Public Health
Associations
 FOOD DEMOCRACY OR FOOD CONTROL? 261

knowledge waiting to inform food governance and to encourage

a change of policy direction but there are few institutions or
mechanisms by which this can happen. The results of three
decades of work in nutrition, epidemiology, medical and
ecological sciences today in effect enables much of society to
recognize the vital need for healthy eating and a life-time diet for
optimum health. And tens of thousands of nutritionists and
health professionals in both the developing and developed world
are, through their professional activities or through policy
involvement, trying to help others to achieve or understand
better health through the food they eat. But progress in imple-
menting population-wide change has been frustratingly slow. Yet
the dynamics of the food supply chain are moving far faster than
policy-making to promote health issues. Policy is reactive too
often. Food governance, over the last half-century, has been
rendered even more problematic by:

l the revolution in food supply and distribution: the lengthen-

ing of the supply chain;
l advances in nutritional understanding;
l changes to the political architecture: the emergence of new
trading blocs and international institutions;
l changing consumer lifestyles: less physical activity, more
women working in the waged labour force;
l population demographics: ageing populations and smaller
households;
l political ideology: the collapse of Communism and the
triumph of individualism and free-market politics.

This new ‘architecture’ makes it more challenging to make the

links between different levels of government and the different
food sectors and it is rare too to encounter anyone in government
with an overall vision for food policy, let alone responsibility for
delivering it. By default, an industry-driven vision of the food
supply chain has taken centre-stage. The food supply chain is so
huge and so important, in commercial terms, that it cannot
operate in a policy or paradigm vacuum.
Mediation on the Food Wars is urgently required from the
state; but the state finds it problematic to connect with demo-
cratic tendencies within food cultures.
262 FOOD WARS

CIVIL SOCIETY EMERGES

Part of the challenge for governance is how the state and institu-
tions can engage with the people – hence the emergence of
‘stakeholders’ or civil society. These new processes underline
the importance of NGOs in all walks of life. For example, the US
has 1–2 million NGOs, and by the mid-1990s, about 1 million
NGOs were operating in India, 210,000 in Brazil, 96,000 in
the Philippines, 27,000 in Chile, 20,000 in Egypt and 11,000 in
Thailand.4 A key priority of governance is to understand and
define the role of NGOs in the policy process. While some NGOs
have established a loud voice and a strong presence in food
policy in recent years, they have yet to convert these into a firm
position in terms of delivery and actively shaping overall policy
integration.
Historically, until a quarter of a century ago, the representa-
tion of civil society in food and health policy was relatively weak,
but, towards the end of the 20th century, activism grew dramatic-
ally over a whole series of food and health issues such as baby
foods, labelling, contaminants, genetic modification, animal wel-
fare, farming practices, labour rights, social justice and hunger.
Despite this flowering, however, there has not been the large
organized food equivalents of such environmental groups as
Greenpeace, Friends of the Earth and the Worldwide Fund for
Nature (WWF). NGOs have led representations, for example, on
hunger and on the inappropriate marketing of infant formulae
and breastmilk substitutes – which engendered a formidable
global coalition in the form of the International Baby Food Action
Network (IBFAN), but these are exceptions in public health. The
public health world is, however, disproportionately dominated
by more powerful organizations at the professional end of the
lobbying spectrum, and industry relatively highly funded and
well represented in the corridors of food governance.5, 6, 7 Now
governance must address the changing influence and emergence
of new coalitions of interest.
Food and health discourse within government has been
strongly led by scientific interests focused on the health benefits
of the different components of foodstuffs. The epidemiological
and public health arguments outlined in Chapter 2 have tended
to be downplayed. The arrival of better coordinated NGO
activism into the global food and health world would be surely
 FOOD DEMOCRACY OR FOOD CONTROL? 263

welcome. 8 As the evidence of the nutrition transition has

emerged, there are clearly good grounds to campaign about the
negative health effects of Western foods, for example, particularly
with the opening up of national markets following the liberaliza-
tion of global trade. There is a strong need for sharing information
about the international marketing practices of giant corporations
across the globe. For example, the publicity engendered by the
McDonald’s legal case against two British activists in the early
1990s spawned many support groups which continued to put the
spotlight on corporate activity in food and health long after the
trial was over.9
Often, in the face of emerging activism, the food industry’s
strategy is to deny links between consumption and ill health,
while agreeing to fund scientists to study their product’s risks
and to adopt new softer tactics such as corporate social respons-
ibility when confronted with the evidence. (Such was the tobacco
industry’s defence of its interests.) But often such defensive
tactics are designed merely to limit the ingress of more radical
thinking. If corporate accountability is to be real, it has to be more
than skin-deep; otherwise it can be dismissed as ‘greenwash’.10
The reductions to conflict between civil society and certain
commercial interests at least require the state to take a more pro-
active role in food and health governance, specifically.11

BUILDING ON EXISTING POLICY

COMMITMENTS
Besides their national commitments and policy objectives,
governments are often already signed up to existing commit-
ments which signal the directions food and health policy could
take. Table 7.3 gives a list of some key global commitments to
nutrition, food safety and wider sustainable development. These
go back to the founding of the UN system in the 1940s, with some
governments placing a stronger emphasis on aspects of food and
health than others. The point is that there is along history of
formal concern; but these attempts are far from being consistently
integrated.
Such global commitments are reminders that there is not a
policy vacuum: health is well-trodden territory. In theory, the
264 FOOD WARS

Table 7.3 List of global commitments

Occasion Date Nutrition Safety Sustainable

food supply
Universal Declaration of Human 1948 + +
Rights
UN Covenant on Economic, Social 1966 +
and Cultural Rights
Stockholm Environment and 1972 +
Development Conference
World Food Conference (Universal 1974 + +
Declaration on the Eradication of
Hunger and Malnutrition)
Convention on the Rights of the 1989 + +
Child
Innocenti Declaration on 1991 + +
Breastfeeding
UN Conference on Environment 1992 +
and Development and Rio
Declaration, UN Framework
Convention on Climate Change
and on Biological Diversity
International Conference on 1992 + + +
Nutrition
World Conference on Human 1993 + +
Rights, Vienna, and Vienna
Declaration and Programme of
Action
UN Fourth World Conference on 1995 + +
Women and Beijing Declaration
and Platform for Action
World Food Summit 1996 + + +
UN Habitat 2 and Istanbul
Declaration 1996 +
UN General Comment on the 1999 + + +
Right to Adequate Food12
World Health Assembly 2000 + + +
(Resolutions
53.15, 51.17, 53.18)
World Food Summit (Rome) 2002 + + +
World Summit on Sustainable 2002 + + +
Development (Johannesburg)
 FOOD DEMOCRACY OR FOOD CONTROL? 265

nutrition transition and the environmental degradation from

intensive food production systems ought to be addressed with
such policy frameworks in place, but the resolutions, binding
agreements and commitments are often not, in reality, followed
up at the national level or supported by adequate funding. In the
real world of politics, sustainable development takes a lower
priority than conventional approaches to trade and economic
growth; just as ‘health’ is perceived as the budget line that can be
raised only if the economy can afford it, so ‘sustainable develop-
ment’ is defined as something that can be bolted on rather than
transform what is meant by economics.13 Nutrition is deemed a
matter for health ministries generally, not something that should
concern the Ministry of Culture or Trade specifically. Food safety
is the problem of food agencies or ministries of agriculture or
health, not the concern of the Finance Ministry unless or until the
bill becomes too high. This compartmentalization must be tackled.

HOW GLOBAL INSTITUTIONS FRAME FOOD

AND HEALTH

Trade has long been the totem pole around which much
agricultural and food politics dances. 14, 15 At the great agri-
culture and food conferences of the 1940s at which Productionism
was put in place – in 1942 at Hot Springs, 1945 in Quebec, 1947 in
Washington DC and 1948 in Cairo 16 – a keen conviction was
expressed that the optimum way to deliver health was by raising
the quantity of food and selling and transporting it to the people.
In our modern food world, the focus has shifted from the national
to the global and regional. Yet institutions of governance are by
and large local or national; the EU is exceptional. Attempts to
internationalize decision-making for the common good are
locked into regional or sectional politics framed by rich nations.
UN bodies such as the FAO, WHO, UNICEF, UNCTAD and
UNEP were sidelined by the creation of the WTO in 1994, and by
the political and economic policy supremacy of financial institu-
tions (also set up in the 1940s) such as the World Bank and the
International Monetary Fund.
The General Agreement on Tariffs and Trade (GATT) is a set
of trading rules now overseen by the WTO. Like the UN, the
266 FOOD WARS

GATT came into existence in the 1940s and was signed in

1948 by two dozen countries committed to reducing tariffs and
barriers to trade and to trade as the means to development and
wealth-creation. Food issues under the provisions of the GATT
were slow to be incorporated because of resistance from the
developed countries, but finally, at the so-called Uruguay Round,
the GATT was revised in 1994 to include a huge set of trade-
related rules for food and agriculture. This is now policed and
developed by the WTO secretariat.
Besides its general commitment to trade liberalization, the
GATT contains a number of subsidiary agreements, such as the
Agreement on Agriculture (AoA), on Technical Barriers to Trade
(TBT) and Sanitary and Phytosanitary Standards (SPS), where
food and health issues are encoded. The US and the EU fought
hard in the Uruguay Round and thereafter to position their
agricultures to advantage and to protect the interests of their food
industries, in particular their positions on biotechnology. This
saw the rich world protecting its trade interests against weaker
and less-subsidized agricultural exporting countries, known as
the Cairns Group (17 agriculture-exporting countries committed
to a market-oriented trading system) and the informal ‘Like
Minded Group’ of developing countries. Non-exporting countries
have been much weaker, yet are dependent upon world prices
that are the outcome.17
This balance of forces was dramatically altered at the meeting
in September 2003 at Cancun, Mexico. Previously, campaigners
had sought to inject into the WTO’s Agreement on Agriculture
special conditions such as a ‘development box’, to protect
developing country’s interests, but the confrontation in Cancun
side-stepped such strategies. There, to EU and US negotiators’
astonishment, a group of 21 countries from the South led by
Brazil, China and India emerged and confronted the food
hyperpowers. The new G-21 Group took a hard line, demanding
that the US and the EU reduce their barriers, cut subsidies and
open up markets to their cheaper commodities,18, 19 without
which conditions it would not entertain any kind of agreement.
It presented evidence of the poor being penalized, indicating
that, in rich countries, agriculture represents less than 2
per cent of total national income and employment, whereas in
middle-income countries, agriculture accounts for 17 per cent
of GDP, rising to 35 per cent in the poorest countries; yet the
 FOOD DEMOCRACY OR FOOD CONTROL? 267

interests of ‘rich country’ agribusiness has predominated. G-21

said that enough was enough. As a result of this pressure, the
entire Cancun negotiations went into abeyance, with the chal-
lenge from civil society groups for the West to deliver a more
equitable food economy ringing loud. Pressure on the EU and US
to reform their highly subsidized agricultures intensified; but
their response was to threaten a return to bilateral trade agree-
ments. The US 2002 Farm Bill had donated $52 billion to crop and
dairy subsidies, increasing them by 67 per cent.20 Small farmers
and growers in the developing world simply cannot compete
with these deep pockets. It should be noted that even within rich
regions, subsidies can be highly discriminatory. For instance, in
the US, 60 per cent of farmers receive no support at all, while the
biggest 7 per cent receive 50 per cent of government pay-outs.21

GLOBAL STANDARDS
The SPS (Sanitary and Phytosanitary Standards) agreement
within the GATT is particularly important for food and health.
In 2000, the WTO and the WHO began a process of serious
negotiation, aiming to better understand and monitor the link-
ages between food safety, environment, food security, nutrition
and biotechnology.22 Food safety in particular has been a persist-
ing problem. The 1994 GATT had catapulted a previously low-
key world body, the Codex Alimentarius Commission (‘Codex’),
into the hot seat of setting world food-safety standards as bench-
marks for other nations. While Codex is a UN body, set up in 1965
with the FAO and WHO as its secretariat, it was to be available
to national governments. The 1994 GATT move, however, meant
that Codex set the world standards of arbitration of food trade
disputes.
Codex membership is by national delegations, but these often
contain corporate interests.23 When it was realized that Codex
would have this new powerful arbitration role under the pro-
posed Uruguay Round GATT, a decade-long fight to clean up
Codex procedures ensued.24, 25 After some pressure, there has
been some improvement in governance and procedures: for
example, some NGOs (but only international ones) are now
accorded observer status.26, 27, 28 The working culture of Codex is
one of risk management, taking foods and sectors of food, on a
268 FOOD WARS

one-by-one basis. While the emphasis in Codex is on food safety

and standards in order to facilitate trade, developing countries
stand at limited advantage, lacking the budgets required to
improve their own measures and standards. When country total
health expenditure averages just $4 per capita,29 attendance at
costly meetings such as Codex is problematic. In 2002 there was
a proposal to create a trust fund to aid poorer countries to attend,
but there were worries that this could be funded by the food
industry and compromise objectivity.
Notwithstanding its worthy brief, Codex lacks an overall
vision of how to integrate food and health, and there is little sign
that it is going to address crises such as the worldwide epidemic
of degenerative disease. In addition, Codex is a technocratic
body, dealing with only single issues and unlikely to provide the
necessary leadership in integrating food and public health policy.
Health policy is also suffering as a result of tension between
leading world economic institutions such as the World Bank and
the WTO on the one hand, and the ‘social’ institutions of the UN.
The World Bank’s own experience of investigating national
economies has shown health to be both a barrier to economic
progress and a potential vehicle for development and, while it
has been in the vanguard of promoting the monetarization of
social capital,30 it now realizes the limits of this approach and is
espousing instead the importance of the social bonds and
relationships that hold peoples together and give support in
communities.31 In moving to guide the framing of conditions for
public health, the World Bank has engineered reactions, and the
WTO has responded by trying to alter its image and be more
inclusive. The key issue is accountability and openness in food
and health governance. The WHO has a World Health Assembly
but there is no parallel citizen’s voice for the WTO. Economically,
there is no contest, which is why countries have clamoured to join
the WTO and companies expend considerable effort monitoring
its activities and lobbying their national governments to ensure
their views are pursued.
This heightened political atmosphere about global
governance is both promising and threatening for public health.
On the positive side, as far as improving democracy and
transparency about world negotiations are concerned, NGOs and
developing countries feel much more capable of confronting
entrenched Northern power blocs such as the US and the EU
 FOOD DEMOCRACY OR FOOD CONTROL? 269

(after such successes as managing to delay the Multilateral

Agreement on Investment [MAI], an attempt through the OECD
to introduce a new regime for investment and finance).32, 33 On the
negative side, however, there is still much to be done to educate
the (potential) food and health lobby about the roles and powers
of the GATT and the WTO. A revitalized WHO, under Dr Gro
Harland Brundtland as Director-General during the late 1990s,
began to position itself to assume public health leadership34 and
to embrace a wider role for public health in all aspects of food and
nutrition policy.35 But to do this successfully, the WHO needs to
take a stronger line in the dynamics of the global food system and
to play a fuller part in confronting the compartmentalization of
health.
Indeed, the WHO recognized its need for a new role:36, 37
outlining a broader base for international relations and
collaborative strategies that will place greater emphasis on
international health security to include the health consequences
of trade in commodities harmful to health. The argument is that
major transnational health issues require:

l global intersectoral action through transnational cooperation

and partnerships;
l an enhanced role for international legal instruments,
standard setting and global norms;
l more comprehensive forms of global vigilance, research,
monitoring and assessment;
l global research programmes that concentrate on developing
cost-effective technologies to improve the status of the poor;
l human resource development; and
l ongoing comparative assessments and cross-fertilization of
experiences regarding health system reform.

INJECTING HEALTH INTO REGIONAL

INSTITUTIONS: THE EU CASE
The European Union is an interesting battleground and
illustration of how the new ecological health approach we have
argued for can be helped or hindered. On the one hand, the EU,
through its Common Agricultural Policy (CAP), is a bastion of
270 FOOD WARS

Productionism and a bizarre mix of protectionism, internal

liberalization and external mercantilism. On the other hand, due
to public pressure and food scandals, the EU has experienced a
crisis of confidence and a period of introspection which has
improved its chances for openness and new ideas. While its lack
of a strong health lobby weakens its capacity for the needed inte-
gration of policy, CAP reform is thus a key symbolic battleground
in the midst of our three core paradigms.
The foundation of the CAP was a classic expression of the
Productionist vision for health. With Europe wracked by World
War II and experience of famines (such as that in The Netherlands
in 1944) and food shortages, its priority was to rebuild agri-
culture as a home-grown policy for the reconstruction of post-
War Europe. Enshrined in 1957, it had grown by 2000 to account
for half of all the EU budget, representing 15 Member States.
Public health by contrast only formally entered the EU remit
with the Amsterdam and Maastricht Treaties of the 1990s. The
revised Treaty of Rome, Article 152, states that the European
Commission will take a strong health line in all its policies, but
this is not helped by a small staff in the public health group (while
the Agriculture Directorate has hundreds). To date, the only
health audits of Commission food policies in general and the
CAP in particular have been externally conducted and have not
filtered into mainstream policy-making.39, 40 It was, in fact, in 2003,
the Swedish government which conducted the most compre-
hensive health audit yet of the CAP, producing a radical,
evidence-based set of policy recommendations to:41

l phase out all consumption aid to the manufacturers of dairy

products with a high-fat content
l limit the School Milk Measure to include only milk products
with a low-fat content;
l introduce a school measure for fruit and vegetables;
l develop a plan to phase out tobacco subsidies within a reas-
onable time frame;
l redistribute agricultural support so that it favours the fruit
and vegetable sector and encourages increased consumption.

CAP spent €32.6 billion in production subsidies in 2000. For that

not to be health audited weakens the commitment to audit
policies for health. A 2002 European Council decision finally gave
 FOOD DEMOCRACY OR FOOD CONTROL? 271

the European Commission some decent funds, €312 million over

five years. But much of that was to improve health information.42
The EU’s policies, like its institutions, grow incrementally rather
than through revolutions; the CAP has always been in a constant
state of change, however, giving it some chance for a health
dimension to be injected into it over time. The internal contra-
dictions of CAP have meant that its Productionist orientation has
been under immense internal pressure, and its bill for subsidies
is substantial. In 2002, the EC announced radical plans to move
away from subsidizing commodities and farmers’ production
directly and to start funding rural development in general and
environmental protection in particular.43, 44 It remains to be seen
whether the fiscal burden of the CAP will drop but the policy
shift is significant, even though most focus is on food safety
rather than wider public health. Only time and politics will tell if
the demise of the Productionist paradigm in the CAP will yield
in the direction of the Ecologically Integrated paradigm or the
Life Sciences Integrated paradigm.45
At an individual country level, there are already interesting
integrated policy initiatives underway. For example in Finland,
where almost 90 per cent of the food consumed is produced
nationally, the food industry is working in cooperation with the
entire food production chain to unify activities into a national
quality strategy, developed at the end of the 1990s, aimed at
addressing people’s concerns about the source of their food
products, how they have been produced and who are involved
in the various phases of the production chain. Watchwords for
this strategy are safety, transparency and openness.46 We would
argue that the fourth watchword and strategy goal – currently
missing – should be health. The UK government’s Curry Com-
mission might be another interesting case study to watch for
the level of policy integration. There is pressure for this to
accelerate.47, 48, 49, 50

AGRICULTURE, SUBSIDIES AND HEALTH

At the heart of both the CAP reform process and of global food
governance in general is an international conflict over subsidies.
Currently, subsidies are disproportionately the policy instrument
of rich nations. The total cost of agricultural subsidies in all
272 FOOD WARS

OECD countries in 1998 was some $362 billion dollars, two

and a half times the combined GDP of all the least-developed
countries.51 In 2003 the UN’s world economic survey put world-
wide farm subsidies at over $300 billion,52 an immense fiscal sum
alongside the few million dollars that national governments give
to proactive health education programmes. In the US, too, the
agricultural industry is seen as one of the more powerful lobby
groups: in a three-year period, the food sector contributed around
$25 million to President George W Bush’s and other politicians’
campaigns, and five of the top people running the US Depart-
ment of Agriculture in 2002 were linked to the meat industry.53
The penetration of the corridors of power by such interests raises
questions about the influences on food governance.
The extent of producer subsidies to the farm sector in some
countries is summarized in Table 7.4, using an indicator de-
veloped by the OECD known as the producer support estimate
(PSE). It shows how countries in the so-called Cairns Group
of less subsidized food producers (including Australia, Brazil
and New Zealand) have dramatically lower PSEs than do high
subsidizers such as the EU, the US or Switzerland. Table 7.5 gives
the list of US federal subsidies to agriculture at the end of the 20th
century: fewer than the EU, but seriously dented by President
Bush’s Farm Bill 2002 which announced increased subsidies of
$190 billion over the following decade.
Much international food trade debate and practice in the last
two decades was dominated by USA–EU spats and jockeying for
position: they each accuse the other of unfairly subsidizing their
own agriculture. In fact, both subsidize heavily compared, say,
to a de-regulated farm economy such as New Zealand’s. In 1999,
the estimated producer subsidy equivalent for an EU farmer was
49 per cent, (nearly half his income), whereas for a US farmer it
was 24 per cent and for a New Zealander it was 2 per cent.56
The policy debate about subsidies is often pitched as a battle
between developed and developing countries. In fact, subsidies
are distorted within countries too.57, 58 In the early 1990s the
UK House of Lords estimated that 20 per cent of UK farmers
received 80 per cent of subsidies, a figure often quoted, while a
more recent estimate found that 16 per cent of farm holdings
received 69 per cent of subsidies, and a study by Oxford Univ-
ersity for the UK government in 2003 showed that producers in
six eastern British counties – the ‘grain barons’ – received more
 FOOD DEMOCRACY OR FOOD CONTROL? 273

Table 7.4 Farm subsidies, by country; OECD Producer Support

Estimate, 1986–2001 (US$ millions)54
1986–88 1999– 1999 2000 2001p
2001
Australia USD mn 1285 947 1135 878 827
Percentage PSE 9 5 6 4 4
Canada USD mn 5667 3930 3709 4153 3928
Percentage PSE 34 18 18 19 17
Czech Republic (1) USD mn 1670 655 849 532 585
Percentage PSE 38 19 24 16 17
European Union USD mn 93719 99343 115330 89617 93083
Percentage PSE 42 36 39 34 35
Hungary (1) USD mn 891 881 1151 912 580
Percentage PSE 17 18 23 20 12
Iceland USD mn 193 136 161 139 108
Percentage PSE 74 63 67 62 59
Japan USD mn 49498 51980 53809 54888 47242
Percentage PSE 62 60 61 61 59
Korea USD mn 12120 18170 18335 19337 16838
Percentage PSE 70 66 66 67 64
Mexico USD mn -266 5694 4515 6032 6537
Percentage PSE -1 18 15 19 19
New Zealand USD mn 476 67 77 71 52
Percentage PSE 11 1 1 1 1
Norway USD mn 2628 2274 2511 2138 2173
Percentage PSE 66 66 67 64 67
Poland (1) USD mn 528 1676 2584 997 1447
Percentage PSE 4 12 19 7 10
Slovak Republic (1) USD mn 675 292 389 335 151
Percentage PSE 35 20 25 23 11
Switzerland USD mn 5063 4480 4869 4356 4214
Percentage PSE 73 70 72 70 69
Turkey USD mn 2779 6522 7707 7882 3978
Percentage PSE 14 21 23 24 15
United States USD mn 41839 51256 55433 49333 49001
Percentage PSE 25 23 25 22 21
OECD* USD mn 238936 248302 272563 241599 230744
Percentage PSE 38 33 35 32 31
Notes: p: provisional. NPC: Nominal Protection Coefficient
NAC: Nominal Assistance Coefficient. EU-12 for 1986-94, EU-15 from 1995, EU
includes ex-GDR from 1990.
(1) For Czech Republic, Hungary, Poland and Slovak Republic: the figure in the first
column refers to 1991-93.
*Austria, Finland and Sweden are included in the OECD totals for all years and in
the EU from 1995.
274 FOOD WARS

Table 7.5 US federal subsidies to agriculture, 1997–200155

US Federal subsidies $m 1997 1998 1999 2000 2001

Income subsidies 6120 6001 5046 5049 4046
Price supports – – – 1127 1056
Deficiency payments – 1792 5895 6425 5000
Conservation programmes 1693 1441 1493 1615 1667
Disaster assistance – 2841 7804 8493 3632
Others 257 138 356 190 278
Total 8070 12,213 22,899 22,899 15,679

than £540 million out of the more than £2 billion in CAP aid
which the UK receives annually.59 East Britain’s grain farmers
take £121 from each consumer, whereas other farmers get £41
from each taxpayer, and three out of England’s nine regions take
half the total CAP subsidy received by England.
Even though subsidy figures are inequitable, and economists
argue even over their calculation, supporters of the public health
should look at them carefully. The current Productionist para-
digm is awash with public money in the form of subsidies, which
could be directed towards different ends; there is also an oppor-
tunity to approach finance ministers and treasuries for cost
savings. At present, current food policies and the supply chain
are delivering huge externalized costs. Health-care bills through-
out the world are rising, as we saw in Chapter 2. Taxpayers and
consumers are taking the externalized financial consequences for
current food supply under a number of headings:

l When they buy the food.

l When they pay for health care due to diet-related disease.
l When they pay to subsidize farmers, if their government does
so.
l When no one pays for environmental damage.
l When no one pays for the social and family care of looking
after sick relatives.

Health proponents can link arms with proponents of world and

social justice. Subsidies damage the developing world.60 The
 FOOD DEMOCRACY OR FOOD CONTROL? 275

subsidy system constrains choice by allowing the state to dump

over-production and diet-related health impacts on the rest of the
world. Current subsidies have outlived their historical health
value. What is needed now is not a CAP but a Common Food
Policy, incorporating human and environmental health.

INJECTING THE NEW HEALTH INTO NATIONAL

INSTITUTIONS
There is wide experience of policy interventions on food and
health from which to draw and learn. The US, often derided as
the home of junk food, has also initiated some strong health
actions: it was the first country to introduce mandatory nutrition
labelling on food products with the 1990 Nutrition Labeling
and Education Act; it also introduced alcohol labelling, and
developed a ‘food pyramid’ to explain simply nutritional advice
to consumers;61, 62 it introduced guidelines on public school meals.
Many countries have learned well from such national food and
health education initiatives, even though they may not be strong
enough to compete with, for example, the deep pockets of food
business’ advertising and marketing efforts. Progress is painfully
slow; new strategies and new policy innovation are needed.
A number of Nordic countries too – Finland, Sweden and
Norway – are much celebrated in the public health policy liter-
ature for their efforts at injecting a human health dimension into
their food supply to reduce the incidence of diet-related diseases
and illness. In part, these schemes were medically driven but they
were also inspired by the Scandinavian corporatist, consensual
tradition of social democracy: this attributes to the state a poten-
tially benign and socially responsible role vis à vis the individual
citizen, working with industry, unions and public interest groups
to establish the public good. These countries have evolved work-
able public health policies to address all aspects of food supply.63
More recently, these Scandinavian countries have begun to
extend their policy framework by creating better coordinated
Nutrition and Physical Activity Councils and strategies to tackle
obesity. Norway’s official Nutrition and Food Policy of 1975 was
designed to combat the incidence of cardiovascular disease,
which accounted for around half of all that country’s deaths,64
276 FOOD WARS

and to reduce the proportion of fat in the national diet from 40

per cent to 35 per cent, a goal first achieved in 1991.65, 66 The farm
lobby saw the value of adapting to the emerging diet–health
paradigm and helped introduce an integrated national food
policy, linking agriculture, food processing, consumers and
health and rural affairs.67, 68, 69, 70
In the early 1970s, Finland had the highest rate of coronary
mortality in the world.71 Through a project in North Karelia (a
region with the highest internal rate), the Finnish government
and health services set out to tackle this toll,72 and targeted
smoking, blood-pressure control and diet, with preventive cam-
paigns throughout the country. The proportion of saturated fats
in total fat consumption in Finland declined, while fish and
vegetable consumption rose,73 and a 55 per cent fall in the male
mortality rate from coronary heart disease was recorded in the
period 1972–1992 as a result. And all this health improvement
occurred ‘without the need for extra resource allocation’,74 with
close collaboration between health agencies and the food
industry. The strategy was systematic, with a clear overall vision.
Sweden’s moves towards an integrated food and health
policy was fired first by a food-safety crisis, following a horrific
outbreak of Salmonellosis in the early 1950s which killed 100
people. This led to the setting up of the country’s National Food
Administration which aimed to link food production with high
health standards. Painful though it was, the Swedish farmers
accepted that it was in its long-term interests to meet tougher
health criteria than were internationally stipulated.75
Later, in the 1990s, Sweden reinforced its public and environ-
mental health policy with employment and food quality object-
ives, following heavy criticism about monoculture in forestry and
farming;76 further, both the agriculture and the environment
ministries are developing programmes to reduce fossil fuel and
energy use77 by a factor of four, through increasing technological
sophistication.78 Sweden is also exploring how to achieve tough
targets on reducing greenhouse gases emitted from the entire
food supply chain79 – one of the climate change recommendations
of the WHO, the World Meteorological Organization and the UN
Environment Programme.80
These countries’ efforts to integrate food and agricultural
policies with health goals have entailed energetic professional
and personal commitment from advocates. Interestingly, Sweden,
 FOOD DEMOCRACY OR FOOD CONTROL? 277

like Norway, recognizes the importance of the cultural dimension

of food policy. They both permit no TV food advertisements
targeted at children under 12 years of age,81 a policy much
admired elsewhere for its protection of children from junk food
advertising but hated by the world advertising industry. This
child protection régime is now under attack (led by the British
advertising industry) in the name of creating a common EU-wide
framework on advertising.
Such efforts to integrate food and health are under some
strain, partly due to EU membership and also due to pressure
from globalization and the need to meet the dictates of the GATT.
Respectful as we are about the Nordic experience, it does have
its limitations. The North Karelia initiative, for instance, would
be harder to implement today. In the 1970s, for example, US
culture was less of a force on youth culture. Finland was outside
the EU. There was no multi-channel, satellite TV beaming in
commercial messages.
For all their limitations, the Nordic experiments are enorm-
ously important. They also show the value of thinking about
policy-making in terms of context, culture and process.82 The
Nordic experience is living proof that policy battles can be won
by health interests, that public and environmental health can be
fused with food and agricultural policy, and that improvements
in health can go hand in hand with sound economies.

Agencies: another response to the crisis of

governance?

One response to difficulties in governance has been the setting

up of agencies – government bodies wholly funded out of taxa-
tion, yet which can be presented as ‘independent’ and science-
based. Science policy experience suggests that the key factor in
determining the impact of evidence and views on policy out-
comes may be the framing assumptions which are in place to
start with.83, 84 In respect of food agencies, a key goal has been to
set out to restore public trust in governance. The plethora of
agencies covering environmental protection, medicines and food
safety suggests that the crisis in trust has been extensive. The
creation of such agencies creates another problem, however: how
to integrate multi-sectoral as well as multi-level interests.
278 FOOD WARS

In the UK the Food Standards Agency was created in 2000

after the greatest period of food crisis since World War II, with a
brief of remaining out of environmental affairs and of focusing
mainly on food safety, but also on nutrition. Similarly, the
European Food Safety Authority (EFSA) came into being in 2003
after years of loss of public confidence about standards.85 In
the southern hemisphere too, building on the National Food
Authority of Australia, a food safety body set up in the late 1980s
merged in the early 1990s with New Zealand’s regulatory bodies
to create the Australia–New Zealand Food Authority (ANZFA)
and it was relaunched in 2002 as Food Standards Australia New
Zealand.86 Denmark’s food agency began as an environmental
agency, set up in the 1970s in the wake of concerns about pesti-
cides; it evolved into a multi-sectoral body, first answering to the
Environment Ministry, then to Health, and it is currently re-
integrated into a newly created Ministry of Food, from the ashes
of the old agriculture ministry.87
Another solution to governance problems could lie in
advisory bodies. The post-War generation of food thinkers in the
UK created a Committee on Medical Aspects of Food Policy
(COMA) which, when it was abolished in 2000, was replaced by
a Standing Advisory Committee on Nutrition (SACN) which had
a much narrower remit and lost COMA’s policy-making function.
Specialist advice is clearly needed if policy is to be informed by
evidence, but there is a danger of a real imbalance and a lack of
integration. There needs to be a mechanism built in that gives
governance bodies informed, evidence-led direction. Food Policy
Councils may provide the key: these were proposed at the 1992
International Conference on Nutrition as vehicles through which
the diversity of advice and evidence could be channelled to
policy-makers. When Norway’s Inter-ministerial Council to
coordinate policy implementation was deemed passive, an
advisory body, the National Nutrition Council, filled the vacuum
and, using information as a key weapon, became the institutional
force for injecting health into wider food and social policies.
Former opponents of policy, such as the food and agriculture
industries, found themselves more willing to listen to arguments
from nutritionists and health authorities. The Nutrition Council’s
functions have now been re-integrated into the state machinery,
locating it within the Directorate for Health and Social Welfare
and integrating it with agricultural, fishery, price, consumer and
trade policies as well as educational and research policy.
 FOOD DEMOCRACY OR FOOD CONTROL? 279

Food agencies are an opportunity, at least in theory, to build

creative tension into food governance between the setters of
standards and the measures that they implement.88 Only time
will tell if they will have a truly positive effect. If their role is to
bolster the survival chances of the existing Productionist para-
digm or to pursue one particular paradigm, they will become
objects of contention themselves rather than an agency for con-
flict resolution.

THE EMERGING BATTLE LINES: FOOD

DEMOCRACY VERSUS FOOD CONTROL
The history of food governance can usefully be understood as a
long struggle between two conflicting forces: ‘food democracy’
and ‘food control’: the latter suggests relatively few people
exerting power to shape the food supply; the policy framework
is dirigiste; decisions are ‘top-down’; the views and interests of
others are mediated through the controllers’ eyes; there is limited
dialogue; and few resources are allocated to investigate ranges
of policy options. ‘Food control’ presupposes people, animals,
plants and the environment being controlled in order to maintain
order, authority and predictability.
‘Food democracy’, on the other hand, gives scope for a more
inclusive approach to food policy. Its ethos is ‘bottom-up’, con-
sidering the diversity of views and interests in the mass of the
population and food supply chain; the needs of the many are
favoured over the few; mutuality and symbiosis are pursued.
There is genuinely open debate between alternative and oppos-
ing views. The core assumption of ‘food democracy’ is that the
public good – in this case the ecological and public health – will
be improved by the democratic process.
Some of the clearest examples of ‘food control’ occur in times
of war or under authoritarian political regimes. Forced farm
collectivization and imposition of tightly enforced rationing are
extreme examples. Under wartime circumstances, governments
frequently impose tough regulations and rules, ordering the food
supply chain and rationing access to food. In today’s architecture
of food governance, bodies such as the WTO or EU have con-
sidered powers of control, themselves fought over.89, 90 Whilst
developing nations battle for land, consumers in developed
280 FOOD WARS

countries, more reliant on the market to meet needs, battle for

‘food democracy’ in respect of access to unadulterated food at
affordable prices and of regaining trust in food manufacturing
processes and in the supply chain.
A challenge for ‘food democracy’ is to decide where the public
interest lies and to set food priorities on behalf of and consulting
the wider citizenry – not just consumer organizations but voices
representing all other interests. The emergence of NGO coalitions
across sectors in this respect prefigures what governments ought
to consider too – the integration of previously discrete policy
‘boxes’. But another clear position, coming from the political
right, is to argue that modernization of institutions of governance
is unnecessary and undesirable because the quickest and most
democratic form of governance is the free market and direct
accountability through consumer sovereignty. But there are
problems with this ‘consumer votes’ approach when anti-health
food forces have at their disposal deep pockets to influence the
consumer vote to their ends.

HUMAN LIBERTY AND CONSUMER CHOICE

Central to any discussion of ‘food democracy’ or ‘food control’ is
the question of human liberty. Is health an individual respons-
ibility and decision? Is food a personal affair? If people want to
eat out-of-season foods sourced from the four corners of the
world and if the market will meet their needs, should they not
be allowed to do so? This liberty argument may be superficially
attractive but is ultimately flawed, and the rallying cry of indi-
vidual freedom could be a smokescreen for food sectors main-
taining the right to sell sub-standard foods. Central, too, is the
issue of the state’s role in allocating priorities, rights and
responsibilities for whole populations and societies which ensure
individual as well as collective liberties. One argument con-
sistently raised, not least by food companies, is that modern
consumers have market power through ‘voting’ with their daily
purchases of food and consumption patterns. They luxuriate in
a historically unparalleled range of choice. No one forces them
to consume as they do. It is true that a visit to a hypermarket with
its 20,000 or more items on sale is truly astonishing to those who
have never experienced it. But, from a health perspective, these
 FOOD DEMOCRACY OR FOOD CONTROL? 281

modern cathedrals of choice are in fact the forums in which the

public does its food penance; it consumes now but ‘pays’ later.
This so-called ‘consumer votes’ theory works mainly for the
affluent in both the developed and developing worlds. As we
have seen, consumer prices do not reflect the worldwide picture
of environmental or health costs caused by the nature of the
production and distribution which gave them this extraordinary
range. In addition, despite the apparently wide choice available
to consumers, they often do not have full information as to what
it is that they are choosing between. Labels do not always convey
comprehensive contents or the origins and nature of production.
Food labels cannot really tell the full story of what went into the
food or its health attributes.93
Beneath the patina of consumer choice there often lurks a
creeping homogenization. For instance, there is a shrinkage in the
number of food shops that consumers can patronize: about half
of all the food and drink purchased in the UK now comes from
just 1000 hypermarket outlets controlled by just four dominant
retail players, and in an increasing number of countries levels of
market concentration are not dissimilar. And on supermarket
shelves, it is highly likely that consumers will find only leading
brands in particular product categories. There may have been
10,000 new food items launched annually in Europe in the 1990s,
but only hundreds have survived the brutalities of the com-
petitive retail environment for more than a few months, let alone
years.94
The ‘consumer votes’ theory assumes that consumers frame
for themselves the context within which they choose goods. In
practice, however, rules of trade are made by highly political and
powerful international forces which frame trade policies to suit
their own policy and commercial realities. Even supporters of
the Productionist paradigm agree with civic movements that
the outcome of this process distorts choices within local food
economies.95, 96, 97

CONCLUSION
For food governance to meet the challenges that we have out-
lined in this book, it must engage with the real complexity of
multi-level policy and control, and food policies, institutions and
instruments need to be improved so as to achieve:
282 FOOD WARS

l better coordination between the different levels of govern-

ance in relation to food policy;
l synchronicity of action;
l lack of domination by commercial interests;
l full stakeholder participation giving priority to including
voices previously excluded;
l more imaginative use of participative democracy techniques;
l good research, evaluation and monitoring so as to enable
policy-making to learn, adapt and incorporate solid evidence;
l better mechanisms for getting policy to respond to evidence
and evidence to feed into policy;
l balancing ‘global’ with ‘local’ food policy objectives.

Improving food and health nationally and worldwide is a pro-

cess which requires that policy take public health evidence more
seriously than commercial rhetoric about leaving markets unim-
peded by state rules and intervention; leadership to deliver the
right mix of policy measures; that there is a group of food-
committed citizens who will not take ‘no’ for an answer; and
that there is a commitment to constant improvement in the
policy- and food-delivering process. At the core of the new food
governance must be an iterative process of regular policy review
and an ability to experiment. At its simplest, this process will be
one in which government sets up a policy review leading to
collection of evidence, leading to audit of policy, leading to a
decision to maintain or modify policy; leading to new ideas and
policies being sought, leading to scoping and experimentation,
testing and consideration for policy, leading to a political decision
to change, which then is monitored and upon which evidence is
sought and evaluated.
Much food and health policy suffers an evidence deficit but
there are encouraging signs of change. There remains the even
more important need to link human and ecological health with
culture and science in order to deliver an authentic health-
centred food supply, which in turn requires commitments from
research foundations and funders as well as from governments.
Ultimately, however, only government can set policy frameworks
that have real legitimacy, are truly in the public interests and are
‘food democratic’.
 THE FUTURE 283

CHAPTER 8
THE FUTURE
‘Lay then the axe to the root and teach governments humanity.’

Thomas Paine, 1737–1809

CORE ARGUMENTS
We have seen how there are clear tensions in the policy
framework of food and health. The Productionist para-
digm is fast eroding, not just on human and environmental
health grounds, but also on hard economic grounds. It is
not yet clear how the food supply chain will finally adapt
and respond to the health crisis or which of the other two
paradigms will replace it. The terrain is fissured by the
competing areas for policy, business and science and what
their roles should be. As ever, the relationship between
evidence and policy formulation is problematic, and some
elements of policy are being pursued without or despite
evidence; others are strong in evidence but not strongly
supported by policy consensus and actions. A period of
experimentation is underway in which new solutions to
this crisis are being proposed by the corporate sector,
agriculture and NGOs, and social movements vie with
advocates of corporate responsibility to win the battle for
consumer culture and state attention.
A battle is underway about what the public interest is.
The paradigmatic approach offers a tool to explore various
scenarios for the future and helps to clarify differences and
perspectives between public (as opposed to private) and
corporate policy. Although food policy is highly contested
space, it is now possible to outline distinct policy options,
where health is interpreted and pursued differently. Which
course is ultimately (or temporarily) followed will be
284 FOOD WARS

decided by the strength of forces and ideologies in and

beyond the state and will be framed by the degree of
organization and coordination of the particular paradigm.
Currently, the likely ‘winner’ in the paradigmatic struggle
to replace productionism is the Life Sciences Integrated
paradigm; but this dominance is vulnerable to external
shocks, which may alter the preparedness of consumers to
act, not just think, like citizens with a long-term commit-
ment to ecological sustainability, which is the core of a new
ecological public health. Consumer behaviour is not the
only key factor. The relationships between science, techno-
logy and innovation is being fought over by adherents of
both paradigms.

INTRODUCTION
At the conclusion of this book, we return to its starting point: the
Food Wars are battles over food policy. They occur within and
between states, corporate sectors and civil society; they frame
food’s relationship to health and well-being, on an individual
and a domestic, as well as a population, level. We have shown
that the shape of food and health is determined by such issues
as:

l the cost and affordability of a good diet;

l equitable food distribution within and between countries;
l access to food;
l local, regional or global food sourcing;
l how food is grown, processed and marketed;
l where and how food is bought and consumed;
l food’s impact on the environment;
l food’s role in cultural life;
l the role of science and technology;
l the distribution of power and governance across the supply
chain.

Whether policy-makers make such issues explicit or leave them

implicit, they require policy directives. The challenge, as we
suggested in the last chapter, is for a political grip to be taken of
 THE FUTURE 285

these policy choices in order to optimize population and eco-

logical health, and to assert the public interest.
What are the viable alternatives to the Productionist para-
digm? As we have shown, evidence of the social, economic, envir-
onmental and health problems associated with food supply is
mounting fast. Policy should feed the search for evidence and
evidence should inform policy: there should be mutual feedback.
Ideally, policy is made on best evidence, with data synthesized
on a systematic basis. As one paper has argued: ‘Evidence-based
nutrition is the application of the best available systematically
assembled evidence in setting nutrition policy and practice.’1 In
practice, however, evidence often fails to inform policy: policy-
makers are often just not interested in the evidence because it
embarrasses a politically driven agenda. As we saw in the case
of evidence-based nutrition guidelines, there can be a tortuous
relationship between how such population-oriented advice
ought to be applied and what actual populations eat. The science
of policy-making is inevitably political and experience suggests
that we should not be holding our breath for health to be put at
the heart of food policy processes.
Policy-making is not precise: it is a product of politics and the
(im)balance of forces. It is a matter of timing, mechanized by
champions, vision and imagination – both private and popular.
It is framed by ‘grand’ contexts such as wars and the long sweep
of historical forces.2 Policy-making about food and health is
therefore a social process, informed by different understanding,
as Table 8.1 illustrates.

WHICH PARADIGM WILL TRIUMPH?

Although Productionism is weakening in power and public
appeal, it is uncertain which of the other two paradigms will
replace it for the long term. It is possible, as Thomas Kuhn
originally argued when setting out his view of paradigms
in scientific thought, for the two paradigms to coexist. One
danger with both the Ecologically Integrated and Life Sciences
Integrated paradigms, while they offer divergent scientific view-
points on the worlds of food and health, is the polarization within
‘healthy’ food production between ‘rich’ and ‘poor’ consumers –
those who can afford such foods and those who cannot. We see
Table 8.1 Different approaches to food and health policy, by paradigm

Policy focus Productionist paradigm Life Sciences Integrated Ecologically Integrated paradigm
paradigm
Relationship to general ‘Trickle-down’ theory; Supremacy of individualized Population approach via genuine
economy primacy of market solutions; consumption; Corporation- stakeholder consultation; health as
inequality inevitable led due to need for large economic determinant; inequalities
private sector science require societal action
budgets

Direction for health policy Individual risk; reliance on Public–private partnerships; Social insurance including primary
charity; safety is prime personal insurance; risk care, welfare and public health
concern management and hazards services; sustainability and public
control health are integrated

Approach to diet, disease Implicit acceptance of The right to be ‘unhealthy’; a The right to be well; entire food
and health societal burden of disease; medical problem; individual supply geared to deliver health
inability to act on problems choice is key driver; demand
of over- and under-nutrition will affect supply; niche
markets

Food business Commodity focus; industrial- Commodity focus with Costs internalized where possible;
scale ingredients and niches; underpinned by need to develop more robust mass
processing; costs of ill public costs but subject to production controls; emphasis on
health not included in price pressure to shift costs from ‘natural’ products and processing
of goods public to private
Policy focus Productionist paradigm Life Sciences Integrated Ecologically Integrated paradigm
paradigm
Environment Tendency towards Reinforces monocultural Biodiversity at heart of thinking;
monoculture; limited tendencies but some ecological assumptions;
consideration of costs; rhetorical concern about development of robust ecological
pressure on resources to diversity; gradualist; systems; minimized industrial–
produce food; ad hoc acceptance of importance; chemical use
adjustment; industrial– hi-tech industrial approach to
chemical dependency problems; tries to reduce
industrial–chemical
dependency

Consumer culture Individual responsibility; Access and benefits Societal responsibility based on a
self-protection; according to capacity to pay citizenship model; defined rights as
consumerism dependent on citizenship; authentic stakeholder
willingness to pay as involvement
consumer

Role of the state Minimal involvement; Balance of public and private Sets common framework; provider
avoidance of ‘nanny state’ sector; rhetoric of minimal of resources; corrective lever on
action; resources best left to state accompanied by strong the imbalance between individual
market forces but use of state action in some sectors; and social forces
public subsidy to implement enabling regulation
policy
288 FOOD WARS

such polarization in production as socially unsustainable as well

as unjust: a pool of ill health and inequality in communities acts
as a drag upon society as a whole.3
The Food Wars’ ultimate challenge will, therefore, be to clarify
the organizational and practical aspects of the food supply chain
and to chart its new direction. Childhood obesity, for instance, is
an issue demanding answers about whether to control marketing
and advertising and about moving food culture in a more health-
enhancing direction. Equally, whether or not to adopt GM crops
and whether individualized/personalized nutrition will improve
population health profiles are very real issues which will help
determine which paradigm becomes pre-eminent. Much will also
depend on whether research into cutting-edge issues for each
paradigm receive equal resources and funds. There is real con-
cern that commercial research is overwhelmingly dominated by
investment in the Life Sciences paradigm, with little going into
clarifying evidence on different interpretations of the biological
sciences. Likewise, funding and resources are helplessly skewed
when it comes to public information and education. For every $1
spent by the World Health Organization on trying to improve the
nutrition of the world’s population, $500 are spent by the food
industry on promoting processed foods.4
The key deciding factors as to which paradigm triumphs
overall, and which becomes pre-eminent in the food supply chain
or whether there is a ‘truce’ include:

l the costs of ill health and health care as fiscal burdens;

l environmental pressures such as climate change, energy use
and water shortage and their impact on people;
l the perception, by key opinion-formers, and social groups
with the capacity to pressurize the state, of the risks;
l the role of scientists and other specialists in articulating the
urgency of the health case in public debate;
l the tolerance for levels of food inequalities within and between
societies;
l whether powerful, coherent international alliances promot-
ing ‘food democracy’ emerge;
l the level of public confidence and trust in the food supply
chain and in science and technology;
l the funding available to competing notions of science and
technology in each paradigm;
 THE FUTURE 289

l whether commerce implements social responsibility and

sustainable business practices;
l any unforeseen new crises arising from current food supply
practices.

Much depends, of course, on the balance of forces and resources,

but one thing is certain: the solution to the food supply chain is
too important to leave to chance. Social pressure will win pro-
gressive change. History suggests that, if threatened by contagion,
and presented with evidence that prevention is possible but
requires new policies or infrastructure, people will accept taxes
and discomfort necessary for effective drains or good water
systems or improved housing or transport. Even vested interests
resistant to change will, when they accept the inevitable, support
the flow of funds. Such an era may be upon us in the Food Wars.
Clausewitz, the 19th-century Prussian military tactician,
famously argued that war is politics conducted by other means.5
Food, we have argued here, is an illustration of that dictum. The
battles, the war fronts, and the marshalling of forces all are signs
of powerful interests pursuing their goals. For example, two of
the early cases for the WTO’s trade disputes mechanism were
based around a ‘health’ issue – namely the issue of recombin-
ant BST and beef hormones.6 This led to huge tariffs ($117 million
per year) being imposed by the WTO on the EU for its ban on
hormones, and the US retaliated with a case in 1999 against the
EU on the grounds that its hormone ban was discriminatory and
spurious public health.7 This, and other cases, showed for the
first time how the EU and US giants of world food trade could
be brought to court and be adjudicated against. Further, the
emergence of the G-21 group of countries allied against the EU
and US at the WTO revision talks at Cancun in 2003 was another
illustration of shifting global food politics, as a result of which
even the food power elites have been sensitized to the new world
order,8 and to the delicacy of public opinion.

THE PARADIGMATIC ANALYSIS

We have made much of the value of exploring ideas through the
paradigms and frameworks surrounding food in public policy.
Food is a material and biological reality so deeply entrenched
290 FOOD WARS

that culture as well as social movements are required to help set

new food frameworks and paradigms. Food marketing already
taps into deep cultural mores and beliefs when moulding
consumer behaviour in order to sell food products. It is only
people and organizations and social forces which can take this on
and shape the food economy differently.
If the paradigmatic framework we have outlined is apt, it has
profound implications for the future of the entire food supply
chain. It is not that one paradigm is hostile to industry or to
science and technology, and that the other favours it; on the
contrary, the paradigms offer different approaches to industry, to
consumers, to health, to science and technology, to managing the
environment, and so on. Terms such as ‘lifestyle’ and ‘choice’ that
current policy-makers hold dear will vary in meaning according
to which paradigm holds sway.
Within the Productionist paradigm, the policy emphasis has
been focused on unleashing the productive capacity in the food
supply chain (particularly land and labour) and to aim for
quantity and efficiency of output, defined in terms of yield,
throughput and profitability. Its assumption is that the public
good requires sufficiency and, in turn, that sufficiency will
deliver the public good. In the pre-World War II and post-War
worlds scarred by hunger and maldistribution, this policy made
both short-term and long-term sense. Productionism has in its
time been immensely successful. Output rose dramatically and
more mouths were fed.
So why is the Productionist paradigm under such strain?
First, evidence has mounted about its externalized health
costs: those associated with diet are rising dramatically, expend-
iture on health care is now enormous and there is now a double
burden of disease, due to hunger, degenerative disease, under-
consumption and over- or malconsumption.
Second, there has been a persistent thread of criticism as to
Productionism’s emphasis on quantity before quality. Despite
Productionism’s astonishing production capacity, it has pos-
sessed a tendency to over-production, distorting food processing
and marketing practices without enough consideration for
health outcomes. In addition, the environmental impacts of
intensive agricultural systems, such as residues from pesticides
and damage to wildlife, biodiversity (both on and off the farm)
and diet itself surfaced first, to be followed by more drastic
 THE FUTURE 291

pressures such as water scarcity, falling fish stocks, soil loss and
climate change.
Third, the policy focus of Productionism upon primary
production is no longer in synch with the contemporary food
economy where the shift has been away from the agricultural/
rural sectors to what happens off the farm: that is, away from
production to the new cultures of consumption. Food processors,
retailers and catering/food service sectors have in effect changed
the food economy, with retailers being pre-eminent among these.
The labour process, as well as agricultural policy, has had to
adapt to this competitive change and is marked by low wages
and poor working conditions in many countries.
Fourth, wide-ranging societal changes such as urbanization,
globalization, supermarketization and media-based food culture
now shape rapid dietary shift. The rise in popularity of fats, meats,
soft drinks, sugary and processed foods has accompanied the
decline of indigenous, fresh foods. Although facilitated by trade
liberalization, this emerging ‘globo-food’ culture is not wholly
attributable to the ‘pushing’ or manipulation of consumer tastes,
although huge sums are expended to bend tastes to suit the
products of powerful company sales; consumer aspirations also
‘pull’ these changes: that is, there are consumer aspirations that
Productionism has serviced. But the maximization of output has
not necessarily been good for consumer health, and policy critics
condemn the over-supply of the Productionist era.9, 10
Fifth, there has been a clear failure of policy to address the
health, social and environmental problems associated with Pro-
ductionism in an integrated way. Policy has often been conceived
in a ‘sectoral’ manner and what is needed now is the integration
of sectoral interests in our policy framework. What is the point,
for instance, of increasing food production by using irrigation
if this depletes water tables? Why give advice to consumers to
eat more fish when stocks are in peril or fishing practices are
unsustainable? Too many policy actions that make sense in one
area undermine actions elsewhere, and the overall policy coher-
ence lacking under Productionism is now required. We need to
juxtapose farming not only with sustainability, but also with
health and tackle food safety alongside all other aspects of food-
related health. Instead, too often policy is addressed in discrete
boxes. Partly this is a problem of institutional architecture, but it
is also due to a lack of vision.
292 FOOD WARS

Table 8.2 Features of the Productionist paradigm under contest in the

Food Wars

Policy area Examples of features being contested

Technical Transformation of nature (GM, seeds, land); impact of
intensification; motives for investment and research
(private/corporate financial returns or public goods?);
the use of food processing aids (eg additives)

Commercial Managing corporate power; reliance on fossil fuels; trade

liberalization benefiting some rather than all; market
concentration and competition policy; coincidence of
mass and niche markets’ reliance on ‘cheap’ labour and
low-cost production centres

Health Individualization; emphasis on safety rather than on

degenerative diseases; provision of health care services;
externalized costs borne by society and families; rise of
obesity and diseases such as diabetes

Food culture Globalization, branding and marketing framing choice;

food mores affected by consciousness industries and
rapidity of change; artificial creation of choice and need;
the role of the consumer

Food in society Food justice and the role of trade; inequalities;

simultaneous under- and over-consumption; problems
of access; neuroses associated with food (phobias,
anorexia, etc)

Environment Unsustainability; externalized costs borne by nature;

dramatic fall in biodiversity; pollution, contamination,
residues

Governance Degree of regulation; delineation of the state’s role;

problems of multi-level governance; rise of NGOs and
‘civil’ society; restoration of public trust

These are fundamental, not peripheral, difficulties and explain

why the Productionist paradigm has increasingly become con-
tested. Table 8.2 summarizes some keys areas where the policy
framework, in place from the late 1940s even to the present, needs
an overhaul. A new systemic approach is required. Clear de-
marcations have emerged in health, as we have seen, between an
 THE FUTURE 293

individualized medical model of food and health and a popula-

tion or societal model, both offering the prevention of disease and
illness – one targeting ‘at risk’ individuals and the other develop-
ing population-based strategies.

QUESTIONS EMERGING FROM CIVIL SOCIETY

After decades in which big government and big business have
dominated food policy discourse, the last three decades of the
20th century witnessed a re-emergence of political and public
involvement in food policy in the form of social movements.
These often emerged as ‘single-issue’ campaigns ranging across
such issues as famine, hunger, pesticides, animal welfare, or-
ganics, socially responsible investment, fair trade, labelling,
marketing practices, cooking skills and genetic modification, as
well as disease-specific health conditions such as heart disease or
diabetes. Collectively, food movements have emerged, which
question the status quo and try to bring food, diet, health, the
environment and food culture into wider public consciousness.
These groups questioned the new consumerism and viewed the
technological outpourings of the food supply chain with some
scepticism. Thus, over the last two decades of the century, at first
hesitantly and then with increasing coherence and confidence, a
new worldview emerged. This food counter-culture articulated
that there was an alternative to the mechanistic approach to food
pursued within the Productionist paradigm that was ‘de-
naturing’ and de-valuing food.11 It was driven by full awareness
of the commercial forces controlling the means of food produc-
tion;12, 13 and so, by the time of the WTO meeting in Seattle in
December 1999, a defining moment, the Productionist paradigm
was clearly in trouble, not least due to new social awareness of
how trade rules and competition policy worked in the interests
of the already powerful.14, 15
This crisis of legitimacy was brought to a head by massive
popular and NGO activity against the new global world order,
with mass picketing and demonstrations following the world’s
political elite wherever it gathered – at meetings of the G7, at the
World Economic Forum at Davos in 2001 or at Cancun, Mexico,
in 2003 – aiming to direct political attention towards such issues
294 FOOD WARS

as access to food markets and the distortions of international

farm trade and subsidies. Further issues also meriting public and
political attention must be: competition in food markets; curative
health care, marketing and advertising; and the role of diet in the
increase in rates of degenerative disease.
Civic and popular movements have been both vocal and
effective in articulating elements of the Ecologically Integrated
paradigm. NGOs have been courageous in confrontations over
issues such as contaminants and chemicals in food, GM foods,
world hunger and famine, the impact of trade rules on developing
countries, the advertising of foods, labour conditions and ethical
investment, environmental damage and animal welfare. Scientists
working within the food system have sometimes dismissed these
social movements as either scientifically illiterate and ungrateful
for all the efforts of the food industry in delivering progress and
improvements, and public critics have often been relegated as
pursuing naïve views of health in preferring the ‘natural’ over the
‘artificial’. Nonetheless the public confrontations over Produc-
tionism have done their work in highlighting scientific uncertain-
ties and the need to shape policy on food and health beyond
simply the traditional medical model of health progress.
A food movement which has posed a genuine alternative to
the Productionist paradigm is the sustainable agriculture move-
ment. With gradual momentum, it has begun to provide scientific
and social scientific evidence for the validity of the Ecologically
Integrated paradigm. (Ironically, the Life Sciences Integrated
paradigm is also now attempting to claim the sustainability
agenda for its own legitimacy; but this reinforces the point.) The
agroecology movement,16 for instance, found itself responding to
sustainable agriculture in creating a food agriculture that was not
punitive to ecology.17 It drew upon both science and cultural
experience in testing its own practices and experimenting with
new ways of combining cropping and skills. Sustainable food
systems can both raise output and reduce inputs, while being
more socially equitable, feeding people in need, providing jobs
and being environmentally beneficial (not just benign).18
A country like Cuba has shown what is possible. Faced with
the collapse of its long-term colonial mentor, the Soviet Union,
and in the face of a continued trade blockade from the US, its
neighbour, Cuba had rapidly to transform a large proportion of
its agriculture from sugar to real food; it had to produce food
 THE FUTURE 295

directly for its people without the costly inputs of fertilizers and
pesticides used in the past and paid for by trade in sugar with
the USSR. In the space of a few years, Cuba had developed a
whole new system of agroecology.19 The Cuban approach was
multi-level: central government encouraged community action
and participation but also provided research support and infra-
structure. Cuba provides some evidence that only when countries
accept they are in a crisis will solutions outside the dominant
paradigm be entertained.
Sadly, such dramatic changes on a country-wide basis to-
wards an ecological goal are few and far between. While the
questioning of Productionism and the ambition of an ecological
public health generally remain embryonic, popular movements
– from farmers’ movements such as Via Campesina (the inter-
national farm and peasant coalition)20, the actions of the French
farmers in response to McDonald’s, the Food Justice movements
in the UK21, the work on food justice in Brazil,22 to the farmers’
resistance in India23 and the seikatsu clubs (people’s co-ops) in
Japan24 – express the aspiration to a safe, affordable and accessible
food supply. ‘Food democratic’ pressures are building up and
take many forms: in one country, attempts to rebuild or retain
local foodways and the reduction in food miles; in another
country, attempts to reconnect land with health and to meet basic
human needs. On some fronts, what was ‘fringe’ is now moving
centre-stage: organic agriculture, for example, and some com-
munity supported agriculture (CSA) and urban agriculture,
movements with worldwide voices and recognized at official
levels, receiving varying degrees of political support.
While there is less coherence in urban areas, one develop-
ment is worthy of comment. In both developing and developed
worlds, there is a rebirth of cooperatives and attempts to create
‘alternative’ distribution systems. (The original ‘mutuals’ were
the first organized attempt to create options for the working poor
in the early days of industrialization.) In the UK, for instance, the
old Co-operative Movement, born in the 1840s as the ‘working
person’s friend’, first introduced the supermarket format in
the 1950s, only to be overtaken by smaller independent chains
adopting its own modern methods and marginalized by rapid
retail concentration from the 1970s. It is interesting, then, to see
the ‘Co-op’ with its emphasis on sustainability and health, begin
to reconnect with the modern food movement.25
296 FOOD WARS

Another important challenge to the cultural tenets of pro-

ductionism is the ‘Slow Food’ Movement, founded in Italy but
now developing around the world.26 As its name implies, this
group believes that food should be about pleasure and social
integration: it celebrates local cuisines and produce; it promotes
skills and artisanal food; and it presents a counter-culture to the
ubiquitous fast-food culture born from the restlessness of
modernity and travel on the road.27 Whilst it remains to be seen
whether this movement gains genuine mass appeal, it is certainly
successful in questioning the ethic of cheap and bland ‘globo-
food’ and in celebrating diversity, regionalism and skill.
Localism is another potentially significant cultural move-
ment. In the wake of a growth of global sourcing from around the
world by rich country retailers and traders, new global giants
already exist and are poised to expand dramatically. Yet in
practice, present food supply chains are still overwhelmingly
regional rather than global: factories and workers are more likely
to be regionally located where the food is to be sold. Even some
of the global giants espouse ‘glocalization’ (sic), the ownership
of ‘local’ plants, and brands or fascias which give the illusion
of national branding. It is not just food campaigners who are
interested in the (re)localization of food: major companies are
also looking to target ‘local’ consumers. In the words of Niall
Fitzgerald, the former Co-chair and Chief Executive of Unilever:
‘Every consumer is local. They are driven by who they are, what
they believe in and what the mores and traditions of that society
are.’28 But this trend by large companies to reposition themselves
as ‘authentic’ can also be seen as a sign of some desperation and
a corporate response to consumers’ revolt against the mass-
produced.30
Can reborn localism pose a threat to transnational supply
chains? While there is cheap oil, the search for sources of supply
where land and labour are cheap is likely to encourage the trend
to all-year-round a-seasonality in value chains, while at the same
time, the ‘proximity principle’ – maximizing the production of
those foods that can suitably be grown and produced as locally
as possible – remains popular.30 If consumers have tasted divers-
ity and got used to the ready availability of a far wider range of
foods, can they be persuaded to return to more restricted diets?
It would be short-sighted of any localist movement to prevent
citizens of, for example, Eastern European countries with dire
 THE FUTURE 297

winter climates from having access to fruit and vegetables all

year round. And, it would make little sense in Finland or the
UK, for example, to try to grow mangoes to be able to meet local
demand or to localize production for its own sake. The issues of
cost and of environmental externalities policy-makers will have
to address include: persuading consumers to pay the full price
and take the environmental consequences of their new choices;
or delivering nutritional diversity while skilling growers into
farm practices that ensure biodiversity. How much choice do
consumers really want? Balancing of all environmental, health
and economic considerations is vital to new food policy.
Many food companies see the need for change in how food is
produced and marketed. Yet, while some companies are actively
pursuing only the Life Sciences route, others are hedging their
bets and are considering the Ecologically Integrated paradigm.
There is acute awareness in the corporate sector worldwide that
the loosening of borders which brought such unprecedented
growth and marketing frenzy is now facing some reaction: that
there is unease about quality issues and about the social, environ-
mental and health costs associated with the food revolution of the
last half-century. Companies recognize that they have not been
passive participants in the cultural transition, and they are also
acutely aware of the risks of litigation – particularly in the US – if
health can be shown to have been affected by their actions.
Retailers, in particular, cannot be seen to be unresponsive to
consumers’ concerns, however irrational or rational their views
might seem to the food technologist. Obesity, in particular, is
forcing major corporations to revise their product ranges and
adjust their marketing practices – whether this is cosmetic or
fundamental remains to be seen.
As a direct result of these recognitions, icons of global brand-
ing such as Starbucks and McDonald’s have attempted to integrate
‘corporate social responsibility’ into their everyday business
practices. In 2002, for instance, Starbucks introduced Fair Trade
coffee as part of its product offering and also started sourcing
some milk from cows not injected with the milk-yield-enhancing
Bovine Somatotrophin (BST), a growth-promoting hormone. In
2001, in the US, McDonald’s implemented ‘animal welfare’
measures for its suppliers of eggs, requiring them to a com-
mitment to end de-beaking and increasing ranging space for each
animal; in 2003, the company refined its policy to include phasing
298 FOOD WARS

out of animal growth-promotion antibiotics in the 2.5 billion lb

of chicken, beef and pork it buys annually.31 In 2004, it refined its
nutrition policy to begin to address or neutralize its nutrition
critics by reducing portion sizes.
Unilever, too, has become similarly ‘responsible’: in response
to evidence about the dramatic global loss of fish stocks, it helped
set up the Marine Stewardship Council which campaigns for
the responsible management and protection of fish stocks.
(Unilever has also set up an internal agricultural sustainability
programme.) Such developments show that business can
engage with the ecological discourse and can fund action. To
‘fundamentalist’ critics, these changes may seem small and mere
‘window-dressing’, but they are surely to be welcomed, if only
for the messages they send widely throughout the food value
chain. Ultimately, only external auditing and time will determine
whether such moves are mere tokens of corporate social
accountability (or ‘greenwash’) or real transitions.
Some of these initiatives emanate from within companies
themselves, while others have emerged from civil society demand-
ing corporate change: boards of directors and chief executives
are having to face increasingly literate, well-informed and even
angry shareholders. The Fair Trade movement, for example, has
spawned many initiatives, codes and shareholder actions in
the last two decades. Reminiscent of the reborn Cooperative
Movement, the Fair Trade movement first expressed itself two
centuries ago as a reaction against slavery and colonialism
(many early companies were religion-based, with Quakers estab-
lishing such 19th-century ‘pure food’ companies as Rowntree and
Cadbury), but re-emerged in the 1980s as evidence about poor
working conditions and returns for producers of primary pro-
ducts was uncovered by NGOs and researchers.32, 33 Today, it is
an important force in 17 affluent food countries (particularly for
product sectors such as tea, confectionery and coffee) linking 350
commodity producers and representing 4.5 million farmers in
developing countries.34 Such initiatives deliver health to the
primary producers, whose livelihoods in producing such com-
modities has sometimes been one of near immiseration.35
Part of the appeal of movements like Fair Trade and organ-
ics is their espousal of openness and transparency and their
resolve to put food companies increasingly under scrutiny for
their health impact. Many companies will want to be seen as
 THE FUTURE 299

contributing to public health, or at least to not contributing to ill

health, and this requires new composite systems of auditing
which link different aspects of food (such as ethics, health
and environmental impact) into one format. Companies are
already familiar with producing environmental or social audits,
but this is likely to widen. In the UK, an experiment in develop-
ing a wider auditing of food companies, in this case of leading
food retailers, was launched in 2002 but it wound down in late-
2003 after resistance from the giant food retailers: the ‘Race to the
Top’ project, funded by government and foundations, set out to
develop a composite audit to provide verifiable evidence of
social aspects such as worker conditions, environmental impact
and human and nutritional health,36 but the biggest UK super-
markets ultimately refused to participate, suggesting that they
were more prepared to present themselves as corporate socially
responsible ‘citizens’ on a single-issue basis. The Race to the Top
project with its focus on the multiple dimensions of consumer
concern was entirely consistent with the principles of the Eco-
logically Integrated paradigm.
The emergence of new food alliances is evidence that the
hegemony of Productionism in food policy is cracking. NGOs
and businesses increasingly make strategic decisions to engage
with each other and to put joint heat on governments to deliver
market reform. It is possible that out of this process will come
new policy convergences and configurations. Health through
food, however, has yet to achieve centrality in food governance,
and government policy has yet to deliver the ‘sustainability’ it
promises. If governments continue to allow massive targeting of
food advertisements at children, for instance, is there any wonder
that the political pressure builds up? Governments must deliver
action, from taking a tough stance on the advertising industry to
giving more resources to public education about food skills and
addressing the role of food in affecting long-term health.
A particularly tough issue is competition policy; yet the rapid
concentration of corporate power suggests a rethink of what is
meant by a market is overdue. Is a market local, national, regional
or international? Market share varies according to which geo-
graphy is chosen. Huge food companies will argue that they only
have 2 per cent of global sales, so competitiveness is ensured; but
this may disguise awesome power within regions or particular
market categories. Critics of supermarkets, for instance, have
300 FOOD WARS

argued that current definitions of what a market is need to be

more local and consumer friendly and that competition author-
ities need to be beefed up to protect the consumer interest, includ-
ing how much time or effort they have to spend getting to and
from the shop.37 The International Federation of Agricultural
Producers, a coalition of farmers, has initiated a global data
collection on international concentration in the agricultural
sector.38 This is to be welcomed but the issues need to be thought
through at intergovernmental level. As we showed in Chapter 4,
food power spreads not just in agriculture itself (land owner-
ship), but in farm inputs (chemicals, seeds), logistics (transport,
shipping, aviation), retail distribution and food service. From the
farm crisis and retail crisis, demand for a new world competition
policy seems to be emerging. In the face of high concentration
levels, recourse to voluntary codes of conduct is too weak a
policy response. Voluntarism is no way to address market power.
Cross-border mergers and acquisitions and foreign direct
investment have health implications. They pose challenges to
government and are key drivers of inappropriate food and health
cultures for they do not pay the externalized costs.

WHAT OF THE FUTURE?

The emerging scientific consensus is that there has to be a real
shift if we are to effect behavioural change in serious food issues,
such as obesity: labelling and ‘consumer advice’ constitute a
health policy that is too limited. Can obesity be effectively tackled
by technical fixes such as nutraceuticals or low-fat products, or
by the search for genetic markers which can be manipulated or
responded to? Or is what is needed a combination of dietary
restraint and environmental alterations such as improved trans-
port policies and pricing policies and other measures marked
by the Ecologically Integrated approach? What should be the
emphasis on exercise being built safely into lifestyles? Is a medical-
ized, a cultural or an environmental approach the most effective?
Obesity is a leitmotif for the modern food age, a symbol of surplus
amidst hunger, and of more pragmatic ways of seeing food and
health issues. A new agenda for food policy is emerging which
requires that all sectors of the food world and governments:
 THE FUTURE 301

l integrate public policy across sectors (health, environment,

trade, transport, regulation, welfare and education) and
between levels of governance (global, regional, national and
sub-national/local);
l curtail currently externalized costs and encourage their
re-internalization so that consumer prices are fair and real-
istic and operate properly as a key instrument for market
efficiencies;
l take a long-term approach that can be delivered in incre-
mental short-term and medium-term actions and via reason-
able policy instruments;
l deliver a rational, sustainable food supply that links eco-
logical and population health with citizens’ rights and in an
equitable manner;
l harness existing beneficial trends while side-lining obstacles
and parochialism.

LOOKING FOR A POLITICAL LEAD

Central to our analysis of the policy challenge is the need to
address the extent of change in the food supply chain. The impact
of supermarket concentration, the collapse of rural employment
accompanying urbanization, the environmental externalities, the
difficulty of regulating rapidly changing food markets and
supply chains; all these surely add to the complexity of food
governance. It can be argued that in a transnationalizing world,
‘old’ dirigiste models of food governance may not be appropriate
any more, and a dual system of food standards and ‘rules-setting’
has emerged, one created by the state, the other by companies
setting regimes (such as the Eurepgap system39 which began as
an attempt by some European food companies to agree standards
on pesticide residues, but has become worldwide and broadened
its remit to other food aspirations, and to deliver standardization,
consistency and supply-chain coherence).
What companies are tentatively beginning to do – namely
re-invent food governance – needs to be led by the democratic
process and to be fully accountable. Coherence at and between
all levels of governance is essential: policy needs to move beyond
the current era of appeals, recommendations, commitments, and
302 FOOD WARS

resolutions – all voluntarist – to a tougher era of binding agree-

ments with legal gravitas. The enormity of the nutrition transition
will not be diminished with mere, bland nutritional advice. Food
policy is a political challenge: it requires leadership, ambition
and vision to give coherence to the hitherto uncoordinated. We
challenge ministers and ministries of agriculture, food, fisheries
and health to give this vital process far higher priority. To date,
no country’s government has fully addressed the full range of
problems outlined in this Food Wars thesis.
Data is another vital tool in the Food Wars: too much data that
ought to be in the public domain is commercially confidential;
major companies spend large budgets on consumer information;
the public sector globally has patchy information. Despite admir-
able efforts by the UN bodies, data on some countries is limited.
Without information and best evidence, policy-making can too
easily return to whim and political pragmatism. On the other
hand, we are wary of delaying policy action pending better
information. Often calls for research can be an elegant form of
procrastination. The real deficiencies are, however, the political
will and leadership to confront powerful vested interests.40
Sometimes policy has to be made and actions have to be taken
on the basis of seriously restricted information; but enough is
known about the Food Wars for policy-makers to act on key
issues, and pressure on politicians to give that leadership should
surely mount.
The nearest most countries get to visionary plans of action
are their National Food and Nutrition Action Plans, as recom-
mended by the 1992 International Conference on Nutrition.
Many countries have produced such plans of actions. The prob-
lem is that they do not or cannot confront the combined effects
of the cultural transition and the food supply chain restructuring
that we have described here. The FAO conference to reconvene
its 1996 World Food Summit in 2002, the so-called ‘WFS+5’
conference, was a missed opportunity. It failed to achieve polit-
ical momentum and wide enough support. An immediate task is
for countries to collaborate on new official guidelines that link
nutrition with ecology. None exist at present. Food culture in an
era with abundant choice requires new cultural mores, new rules
for everyday eating and living (see Table 8.3).
We have argued that ultimately only the state (or collectivities
of states) have the leverage to re-frame the direction taken by the
 THE FUTURE 303

Table 8.3 Some tentative rules for food and ecological health (adults)

l Eat simply.
l Eat no more than you expend in energy.
l Encourage supply to deliver to each according to need.
l Eat a plant-based diet with flesh more sparingly, if at all.
l Celebrate variety; eat in a manner that encourages biodiversity in the
field and thence to the plate.
l Eat for nutrition and the environment; think fossil fuels; energy = oil.
l Eat a range of foods of between 20 and 30 species per week.
l Eat seasonally, where possible.
l Eat according to the proximity principle, as locally as you can.
l Support local suppliers; food is work.
l Be prepared to pay the full externalized costs; if you do not, others
will.
l Drink water, not soft drinks.
l Without being neurotic, be aware of the hidden ingredients.
l Enjoy food in the short term, but think about its impact long term.

current powerful forces within the modern food supply chain

and to reclaim the public interest. What used to be termed ‘public’
policy is now a trilateral bargaining of state(s), corporations and
civil society. But only the state can facilitate that process and exert
legal leverage.
It is time to re-invent food and health public policy and to re-
invigorate what is meant by ‘public’ and which strategic goals,
instruments and measures ought to be deployed. The old ‘top-
down’ model of public policy had States deciding what they
wanted to do, and which are the best, most efficient means for
delivering what they set out to do. Taxes and fiscal measures?
Advice, education, information? Regulations and laws? The
patrician state would decide. We do not reject these instruments
but are concerned about the ends to which they are used. Regula-
tions, advice and fiscal measures are still core weapons in the
armoury of the Food Wars. It has been more fashionable and
politically expedient since the 1980s to see mechanisms such as
codes of conduct, the issuing of advice, the publicizing of league
tables of performance and ‘naming and shaming’ and the crea-
tion of voluntarist partnerships rather than the use of legislation
and sanctions. These have their place, but they depend upon
consensus among partners to work. We do not believe that con-
sensus yet exists. The threat of sanction of legal action has to be
304 FOOD WARS

there, and used appropriately. The European food safety crises

of the 1990s led to legislative change and such ‘hard’ policy
measures are more likely to be deployed when state credibility
is at stake.
In the modern era, however, the responsibility of consumers
is also considerable. Too often, governments and companies put
the emphasis on consumers to look after their own health. We
have questioned that policy approach, but modern consumerism
now suggests that consumers will have to become ‘food citizens’;
to think about and eat their food against longer time horizons; to
judge food not just by price but by quality and long-term impact
on health and environment. New cultural mores are required and
need to be integrated. What good is a fair-traded chocolate if it is
poor for health, or is long on food miles? And yet the fair-traded
chocolate gives a decent living – and therefore health – to the
primary producer. A welcome debate about what these social
criteria for food could be needs to start, linking social considera-
tions with human health and environmental health, as well as
economic factors.
These are dynamic times in food policy and in health. The
Food Wars thesis proposes that new approaches to food policy
are emerging,41 with new policy choices and alliances and busi-
ness opportunities. The new era has more complexity, but also
more opportunity for strong alliances to tackle together the forces
of ill health and inequity. For any policy problem, four broad
policy options emerge:

l to do nothing and allow ‘market forces’ to run their course;

l to look to corporate solutions;
l to frame market conditions;
l to empower civil society to demand and consume differently.

These broad policy options are expanded in Table 8.4 which gives
a typology of some general policy directions and options.
We are optimistic. We see signs of pressure to re-invigorate
food and health policy: to deliver human and ecological health
combining efficiency with authenticity and integrity. Some of the
key variables likely to determine the future of food include:

l the relative strength of social forces and ideologies in and

beyond the state;
Table 8.4 Some broad policy options for tackling food and health

Policy option Key player Strategic focus Examples of

actions and instruments
1 Laisser-faire (ie do The ‘hands off’ state Allow market dynamics ‘It’s all too late’; ‘leave it to Wal-Mart’
nothing/give up) to run their course
The ‘monitoring’ state Collect more data ‘We do not know enough to act’ → data collection;
monitoring
2 Corporate action Corporate sector Product New product development (eg functional foods);
standards-setting
Technology New processes
Prices Reduction of transaction costs*
Corporate social Voluntary labelling; industry-wide partnerships; consumer
responsibility information; voluntary auditing and data
Insurance Reward positive health behaviour through premiums
3 Frame market conditions State–corporate–civil Investment R&D support; company audits; use of pension funds to
society partnerships, invest in healthy foods
politically led processes
(ie state)
Fiscal measures Tax (fat, energy, marketing etc)
Competition policy Set travel-to-shop definitions; encourage new enterprises
THE FUTURE

Regulations Marketing controls

Alter production Investment; targets; R&D/science and technology; use of
305

public procurement budgets

Table 8.4 (continued)

Policy option Key player Strategic focus Examples of

actions and instruments
306 FOOD WARS

Infrastructure Investment in human capital and physical infrastructure;

update markets;
Standards-setting Guidelines; codes of practice; mandatory regulations; law
enforcement
Institutional architecture Food policy councils; ‘independent’ agencies; reform of
ministries; improved cross-departmental coordination

Education Training; education in schools; consumer advice

4 Civil Society action NGOs, civil society Civil action Campaigns; media coverage
Re-energizing the state Actions on pension investment
Consumer education Parents’ juries; self-help; skills classes in school etc
Law suits Class actions against advertisers/manufacturers

Capacity building Skills training; school-based education on marketing,

nutrition etc
Improved supply chain Develop ‘best practice’ to deliver integrity and authenticity;
alternative supply chains (eg Co-ops; a civil vision for public
procurement)
Note: *Transaction costs are the costs that occur in a product or production chain from one economic agent to the next.
 THE FUTURE 307

l which paradigm dominates, which itself depends on political

commitment and external pressure;
l how health is conceived – as an individual or a population
issue;
l whether the environment is seen as an infrastructure for
health or as a separate policy ‘box’;
l public pressure and the preparedness of consumers to act, not
just think, like citizens with a long-term commitment to
ecological sustainability;
l the degree of organization and coordination among forces
adhering to particular paradigms;
l food insecurity taking hold in the developed world as well
as the developing world: if drought or other ecological crisis
occurred.

Food is such an enormous sector of the economy, so vital to

people’s needs and contexts and so powerfully fought over by
companies wishing to capture markets that conflict is inevitable.
The Productionist paradigm is on the way out. Currently the Life
Sciences Integrated paradigm has most of the big commercial
backing; far more resources need to be put into policies from
within the Ecologically Integrated paradigm. This paradigm,
while seriously under-funded, holds great promise, not least in
meeting the environmental determinants of human survival.
Even if the Life Sciences paradigm reduces its reliance on GM
and exploitation of biology, we think it would still be folly for
governments to rely on it; it is the Ecological paradigm which
deserves stronger backing. As we have sought to show, there is
an emerging and remarkable concern for both environmental and
human health interests from within the Ecologically Integrated
paradigm: a diet that is good for biodiversity is also good for
human health, providing a rich variety of nutrients. In this very
practical sense, as well as in theory, the goal of food and health
policy surely must be for humanity to be at one with nature. But
culture, as ever, might turn out to be the defining arbiter.
308 FOOD WARS

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45 Reuters (2003) ‘Green Light for Global Study on Food Security’,
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46 Hendrickson, M, Heffernan, WD, Howard, PH and Heffernan, JB
(2001) Consolidation in Food Retailing and Dairy: Implications for
Farmers and Consumers in a Global System: Report to National Farmers
Union (USA), Columbia, Missouri: Dept Rural Sociology University
of Missouri
47 Goodman, D and Redclift, M (1991) Refashioning Nature: Food,
Ecology and Culture, London: Routledge
48 Magdoff, F, Buttel, FH and Foster, JB (eds) (1998) ‘Hungry for Profit’,
Monthly Review, 50, 3, pp1–160
 NOTES AND REFERENCES 329

49 National Farmers’ Union (2002) press release, 9 July 2002, London:

National Farmers’ Union
50 Lilliston, B and Ritchie, N (2000) ‘Freedom to Fail’, Multinational
Monitor, July/August, pp9–12
51 Halweil, B (2000) ‘Where have all the farmers gone?’ World-Watch
Sept/Oct vol 13, no 5, pp12–28
52 Watkins, K (2002) Rigged Rules and Double Standards, Oxford: Oxfam
International
53 Friends of the Earth International (1999) The world trade system:
winners and losers, London: FOE-I
54 Agrow World Crop Protection News (2002) ‘Gap narrows between
prospective agrochemical market leaders’, 397, 1; and Agrow, passim
55 National Farmers’ Union (2000) The Farm Crisis, EU Subsidies, and
Agribusiness Market Power, Report presented to the Senate Standing
Committee on Agriculture and Forestry, Ottawa, Ontario, 17 February
56 National Farmers’ Union (2002) ‘Free Trade: Is it working for
farmers?’, Saskatoon, Sask.: National Farmers’ Union of Canada,
http://www.nfu.ca
57 OECD (1999) Agricultural Policies in OECD countries: Monitoring and
Evaluation 1999, Paris: OECD
58 Banana Link (2003) The Banana ‘Split’. http://www.bananalink.
org.uk/
59 Banana Link (2003) Race to the Bottom. http://www.bananalink.
org.uk/
60 Wilson, N (1996) ‘Supply Chain Management: A Case Study of a
Dedicated Supply Chain for Bananas in the UK Grocery Market’,
Supply Chain Management, vol 1, no 1 pp39–46
61 Robbins, P (2003) Stolen Fruit: the tropical commodities disaster,
London: Zed Press
62 Barrett, H, Ilbery, BW, Browne, AW and Binns, T (1999) Globalization
and the changing networks of food supply: the importation of fresh
horticultural produce from Kenya into the UK, Trans Inst Br Geogr
NS 24 pp159–174
63 Data from Chen, Y (2001) Analysis of the Competitiveness of China’s
Onion and Broccoli Exports to Japan, Ehime University, Japan
64 Leatherhead Food RA (2001) Food News, vol 35, no 11, November, p2
65 Deboo, M (2002) ‘Winners and Losers’, The Grocer, 11 May, pp27–30
66 Data from CIAA, Brussels. http://www.ciaa.be
67 OECD (1981) Food Policy, Paris: Organisation for Economic Co-
operation and Development
68 Longfield, J (1992) ‘Information and advertising’ in National Con-
sumer Council, Your Food, Whose Choice? London: The Stationery
Office
69 Source: http://www.productscan.com
70 From company reports
330 FOOD WARS

71 Cocaine, caffeine and alcohol, see http://www.lewrockwell.com/

jarvis/jarvis17.html and http://www.foodreference.com/html/
fcocacola.html
72 Teather, D (1999) ‘Ice-cold Coke reacts calmly to crisis’, The Guardian,
25 June
73 Martinson, J (2001) ‘Why Coke’s no longer the real thing’, The
Guardian, 14 August
74 Speeches and other Coca-Cola facts accessed from company
website: http://www.cocoa-cola.com
75 Unilever (2000) ‘Unilever plans faster growth’, press release, 22
February, London: Unilever
76 Fortune Magazine, http://www.fortune.com, accessed 25 February
2003
77 Feeney, J (consumer products analyst at investment firm SunTrust
Robinson Humphrey) quoted in Hopkins, J (2003) ‘US economy
follows the Wal-Mart way’, USA Today, 3 February
78 IGD (2002) Global Retailing, Institute of Grocery Retailing, Letchmore
Health, p113
79 IGD (2001) ‘European Grocery Retailing’, press release, 26 February,
Institute of Grocery Distribution, Letchmore Heath
80 Vorley, W (2003) Food, Inc: Corporate Concentration from Farm to Con-
sumer, London: UK Food Group, October, http://www.ukfg.org.uk
81 Grievink, J.-W. (2003) ‘The Changing Face of the Global Food Supply
Chain’, paper presented at OECD Conference on Changing Dimen-
sions of the Food Economy, The Hague, 6–7 February, http://
webdomino1.oecd.org/comnet/agr/foodeco.nsf
82 Dobson, P, Clarke, R, Davies, S and Waterson, M (2001) ‘Buyer
Power and its impact on competition in the food retail distribution
sector of the EU’, Journal of Industry, Competition and Trade, 1, 3,
pp247–281
83 Reardon, T, Timmer, P, Barrett, C and Berdegue, J (2003) ‘The rise of
supermarkets in Africa, Asia, and Latin America’, American Journal
of Agricultural Economics, 85, 5
84 Reardon, T and Berdegue, JA (2002) ‘The rapid rise of supermarkets
in Latin America: challenges and opportunities for development’,
Development Policy Review, 20, 4, 317–334
85 We are grateful to Professor Dinghua Hu of Kyoto University for this
information
86 Reardon, T, Timmer, P, Barrett, C and Berdegue, J (2003) ‘The rise of
supermarkets in Africa, Asia, and Latin America’, American Journal
of Agricultural Economics, 85, 5
87 For further thoughts, particularly on the role of processing capital
in this restructuring, see Wilkinson, J (2002) ‘The Final Foods
Industry and the Changing Face of the Global Agrofood System’,
Sociologia Ruralis, 42, pp329–347
 NOTES AND REFERENCES 331

88 Stanton, J (1999) ‘Rethinking retailers’ fees’, Food Processing, 60, 8,

pp32–34
89 Quoted in Hollinger, P (1999) ‘Carrefour’s revolutionary’, Financial
Times, 4 December
90 See Gabriel, Y and Lang, T (1999) The Unmanageable Consumer,
London: Sage
91 Competition Commission (2000) Report of the Competition Com-
mission on the supply of Groceries from multiple stores in the United
Kingdom, London: Competition Commission (Cm 4842)
92 Competition Commission (2000) Report of the Competition Com-
mission on the supply of Groceries from multiple stores in the United
Kingdom, London: Competition Commission (Cm 4842)
93 IGD (2001) Grocery Retailing 2001, Institute of Grocery Distribution,
Letchmore Heath, p43
94 Competition Commission (2003) Safeway plc and Asda Group Limited
(owned by Wal-Mart Stores Inc); Wm Morrison Supermarkets plc;
J Sainsbury plc; and Tesco plc. A report on the mergers in contemplation,
London: Competition Commission, September
95 Euromonitor International (2001) The world market for consumer
foodservice 2001, London: Euromonitor
96 Euromonitor International (2001) The World Market for Consumer
Foodservice, London, Euromonitor, p52
97 ibid, p163
98 ibid, p52
99 Schlosser, E (2001) Fast Food Nation, Boston MA: Houghton Mifflin
100 Burger King, company data, supplied to authors, April 2002
101 Heasman, M (2003) ‘Weighty matters loom large’, Innova, 1, 1 CWS
Media, The Netherlands
102 Biing-Hwan, L, Guthrie, J and Frazao, E (1998) ‘Popularity of
dining out present barrier to dietary improvements’, Food Review
(USDA), May/August, pp2–10
103 Mason, J (2001) ‘New farming techniques could “cut food crisis in
south Asia”’, Financial Times, 3 October, p12
104 Sloan, E (2002) The Natural & Organic Foods Marketplace, Food
Technology, vol 56, no 1, pp27–37
105 NBJ (2001) Organic foods report 2001, San Diego: Nutrition Business
Journal, http://www.nutritionbusiness.com
106 Data from www.organic-europe.net/europe_eu/statistics.asp
107 Yussefi, M and Willer, H (2003) The World of Organic Agriculture,
Imsbach: International Federation of Organic Agriculture Move-
ments
108 Compiled by ITC, January 2002, based on trade estimates, http://
www.intracen.org/mds/sectors/organic/overview.pdf
109 Food Standards Agency (2001) Statement on organics, London: FSA,
16 October
332 FOOD WARS

110 Banks, J and Marsden, T (2001) ‘The Nature of Rural Development:

the organic potential’, Journal of Environmental Policy and Planning,
3, 103–121
111 Data from http://www.isaaa.org
112 Persley, G (2003) New Genetics, Food and Agriculture: Scientific
Discoveries – Societal Dilemmas, Paris: International Council for
Science (ICSU). http://www.icsu.org
113 ETC Group (2002) Ag Biotech Countdown, June 2002 Update,
http://www.etcgroup.org
114 Institute of Food Technologists (USA) (2000) IFT Expert Report on
Biotechnology and Foods, Washington, DC, p54, http://www.ift.
org/pdfs/biotech/report.pdf
115 Leaver, C (2001) Food for thought, 28th Bawden Memorial Lecture.
Brighton: British Crop Protection Council Conference, http://
www.bcpc.org
116 Persley, G (2003) New Genetics, Food and Agriculture: Scientific
Discoveries – Societal Dilemmas, Paris: International Council for
Science (ICSU), http://www.icsu.org
117 Royal Society (1998) Genetically Modified Plants for Food Use,
London: Royal Society
118 Letter from the English Nature Chairman, Baroness Young of Old
Scone, to the Prime Minister, the Rt Hon Tony Blair MP, 4 February
1999 (English Nature ref. PO/04.13 & 08.02/5361)
119 GM Science Review Panel (2003) First Report. London: Department
of Environment, Food and Rural Affairs, http://www.
gmsciencedebate.org.uk/report/
120 United Nations Development Programme (2001) Human Develop-
ment Report: Making new technologies work for human, US: Oxford
University Press (also available on http://www.undp.org/hdro)
121 ibid
122 Shiva, V (1993) Monocultures of the Mind, Penang: Third World
Network
123 Shiva, V (1997), Biopiracy: the plunder of nature and knowledge, Boston
MA: South End Press
124 Fowler, C and Mooney, C (1990) Shattering: food, politics, and the loss
of genetic diversity, Tucson: University of Arizona Press
125 Altieri, M and Rosset, P (1999) ‘Ten reasons why biotechnology will
not ensure food security, protect the environment and reduce
poverty in the developing world’, AgBio Forum, 2, 3 & 4, http://
www.agbioforum.org
126 de la Perriere, R and Seuret, F (2000) Brave New Seeds: The threat of
GM crops to farmers, London: Zed Books
 NOTES AND REFERENCES 333

CHAPTER 5
1 Goody, J (1982) Cooking, cuisine and class, Cambridge: Cambridge
University Press
2 Murcott, A (1982) ‘On the social significance of the “cooked dinner”
in South Wales’, Social Science Information, 21, pp677–695
3 Warde, A (1997) Consumer, Food and Taste, London: Sage
4 Mintz, S (1996) Tasting Food, Tasting Freedom, Boston MA: Beacon
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5 Bourdieu, P (1984). Distinction: A Social Critique of the Judgement of
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6 Latouche, S (1993) In the wake of the affluent society, London: Zed
7 Norberg Hodge, H (1991) Ancient Futures, San Francisco: Sierra Club
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8 Levett, R (2003) A Better Choice of Choice: Quality of Life, Consumption
and Economic Growth, London: Fabian Society
9 Jackson, T and Michaels, L (2003) Policies for Sustainable Consump-
tions, A Report to the Sustainable Development Commission, Guildford:
University of Surrey/Oxford: Environment Change Institute
10 IEFS (1996) A pan-EU survey of Consumer Attitudes to Food, Nutrition
and Health, Report number 1, Dublin: Institute of European Food
Studies
11 IEFS (1996) A pan-EU survey of Consumer Attitudes to Food, Nutrition
and Health: influences on food choice and sources of information on healthy
eating, Report No. 2, Dublin: Institute of European Food Studies
12 IEFS (1996) A pan-EU survey of Consumer Attitudes to Food, Nutrition
and Health: definitions of healthy eating, barriers to healthy and benefits
of healthy eating, Report No. 3, Dublin: Institute of European Food
Studies
13 IEFS (1996). A pan-EU survey of Consumer Attitudes to Food, Nutrition
and Health: dietary changes, Report No. 4, Dublin: Institute of Euro-
pean Food Studies
14 Health Focus (2001) Study of Public Attitudes and Actions Towards
Shopping and Eating, Atlanta: HealthFocus Inc., http://www.
healthfocus.net
15 ibid
16 Food Science Australia (1999) The future of food-related innovation.
Report of Project Cassandra, Sydney: Food Science Australia
17 Orbach, S (1986) Hunger Strike: The Anorectic’s Struggle as a Metaphor
for our Age, New York: W W Norton & Co
18 Lansley, S (1994) After the Gold Rush: the trouble with affluence,
London: Century
19 Latouche, S (1993) In the wake of Affluent Society, London: Zed Press
334 FOOD WARS

20 Durning, AT (1992) How much is enough?: the consumer society and the
future of the earth, London: Earthscan
21 Redclift, M (1996) Wasted: Counting the Costs of Global Consumption,
London: Earthscan
22 See http://www.slowfood.com
23 Barling, D (2000) ‘Regulating GM foods in the 1980s and 1990s’
in Smith, DF and Phillips, J Food, Science, Policy and Regulation in the
20th Century: international and comparative perspectives, London:
Routledge
24 Shiva, V (2000) Stolen Harvest: the hijacking of the global food supply,
Cambridge MA: South End Press
25 Klein, N (2000) No Logo, London: Flamingo
26 Vidal, J (1997) McLibel: burger culture on trial, London: Pan
27 Salaman, R (1949) The History and Social Influence of the Potato,
Cambridge: Cambridge University Press
28 Schlosser, E (2000) Fast food nation, London: Penguin
29 Hobhouse, H (1992) Seeds of Change: five plants that transformed
mankind, London: Papermac, p214
30 Mintz, S (1985) Sweetness and Power: the place of sugar in modern
history, Harmondsworth: Penguin
31 Hobhouse, H ( 1992) Seeds of Change: five plants that transformed
mankind, London: Papermac, p43ff
32 Ritzer, G (1992) McDonaldization of Society, Thousand Oaks CA: Sage
33 Jakle, JA and Sculle, KA (1999) Fast food: Roadside Restaurants in the
Automobile Age, Baltimore: Johns Hopkins University Press
34 Dickinson, R and Hollander, SC (1991) ‘Consumer Votes’, Journal of
Business Research, 23, 1, pp9–20
35 Ewan, S (1992) ‘From Citizen to Consumer?’, Intermedia, 20, 3, May–
June, p23
36 Baudrillard, J (1970/1998) The Consumer Society: Myths and Struc-
tures, London: Sage
37 Lang, T (1998) ‘Towards a food democracy’, in Griffiths, Sian (ed),
Consuming Passions, Manchester: Manchester University Press,
pp13–24
38 Adapted from Lang, T (1999) ‘Diet, health and globalisation: five key
questions’, Proceedings of the Nutrition Society, vol 58, pp335–343
39 Kaeferstein, FK, Motarjemi, Y and Bettcher, DW (1997) ‘Foodborne
Disease Control: A Transnational Challenge’, Emerging Infectious
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40 Galbraith, JK (1992) Culture of Contentment, Boston MA: Houghton
Mifflin
41 Lang, T (1995) ‘The contradictions of food labelling policy’, Informa-
tion Design Journal, 8, 1, pp3–16
42 Norberg-Hodge, H (1992) Ancient Futures, San Francisco: Sierra
Club Books
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43 Wackernagel, M and Rees, W (1996) Our Ecological Footprint: reducing

human impact on the earth, Gabriola Island, BC/Philadelphia PA:
New Society Publishers
44 Barlow, M (2000) Blue Gold: the global water crisis and the commodifica-
tion of the world’s water supply, San Francisco: International Forum on
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45 Barlow, M (2000) ‘Commodification of water – wrong prescription’,
speech to 10th Stockholm Water Synmposium, 17 August
46 Ritzer, G (1999) Enchanting a Disenchanted World, Thousand Oaks:
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47 Expanded from Durning, A T (1992) How Much is Enough?, Wash-
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48 Appleton, J (1987) Drought Relief in Ethiopia: planning and management
of feeding programmes – a practical guide, London: Save the Children
49 Walton, JK (1992) Fish and Chips and the British Working Class, 1870–
1940, Leicester: Leicester University Press
50 Maslow, AH (1970) Motivation and Personality, New York: Harper
and Row, 2nd edition
51 Maslow, AH (1973) The Farther Reaches of Human Nature, Harmonds-
worth: Penguin
52 Ingwerson, J (2000) ‘US food industry targets biotech education’,
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53 ibid
54 Heasman, M and Mellentin, J (2001) Strategies in Functional Foods and
Beverages 2002, Brentford: New Nutrition Business, Dec/Jan
55 Dibb, S (1993) Children: Advertisers’ dream, Nutrition nightmare?
London: National Food Alliance
56 Young, B (1998) Childrens’ categorisation of food, London: Food
Advertising Unit
57 Barwise, P (1994) Children, Advertising and Nutrition, London: The
Advertising Association
58 Advertising Statistics Yearbook 2001, Table 20.5, Unadjusted (at rate-
card) ACNielson-MMS expenditure by product group, pp210–211
59 Marketing, http://www.marketing.haynet.com/feature00/big
brands00/top50.htm (accessed 2001)
60 Adex International, Nielsen Media Research, 2002 (contact: adex.
[email protected]); http://www.mind-advertising.
com/us/index.html
61 Perry, M (1994) The Brand – Vehicle for Value in a Changing Marketplace,
Advertising Association, President’s Lecture, London, 7 July 1994
62 Cecchini, P (1988) The European Challenge, London: Wildwood House
63 Consumers’ Association (2001) ‘The True Cost of Promotion in
Schools’, Which?, December, pp8–10
64 Rayner, G (2002) ‘McDonald’s and UNICEF: the odd couple?’,
Guardian Unlimited, http://www.guardianunlimited.co.uk, August
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65 Wiseman, MJ (1990) ‘Government: where does nutrition policy come

from?’, Proceedings of the Nutrition Society, 49, pp397–401
66 Lang, T (1995) ‘The contradictions of food labelling policy’, Informa-
tion Design Journal, 8, 1, pp3–16
67 For example, in the press briefing to coincide with publication of
four regulations on food safety by the European Commission ex
parte Commissioner David Byrne, Health and Consumer Protection
Commissioner, 17 July 2000
68 Department of Health (2003) Health Check. Annual Report of the Chief
Medical Officer 2002, London: Department of Health
69 UBS Warburg (2002) Absolute Risk of Obesity, London: UBS Warburg,
27 November
70 Morgan, JP (2003) Food Manufacture: Obesity Report, London: JP
Morgan, 16 April
71 ibid
72 Dalmeny, K (2003) ‘Food marketing: the role of advertising in child
health’, Consumer Policy Review, vol 13, no 1, pp2–6
73 Dalmeny, K, Hanna, E and Lobstein, T (2003) Broadcasting Bad Health,
London: International Association of Consumer Food Organiza-
tions, July
74 Centre for Social Marketing (2003) Review of Research on the Effects of
Food Promotion to Children, Glasgow: the University of Strathclyde
75 Kraft press release, http://www.kraft.com accessed August 2003
76 Caraher, M, Lang, T and Dixon, P (2000) ‘The influence of TV and
celebrity chefs on public attitudes and behaviour among the English
public’, Journal of the Association for the Study of Food and Society, 4, 1,
pp27–46
77 National Opinion Polls (1997) Taste 2000, Research carried out for
Hammond Communications on Cooking (Geest Foods), London,
UK: National Opinion Polls
78 National Food Alliance (1993) Get Cooking!, London: National Food
Alliance, Department of Health & BBC Good Food
79 Fieldhouse, P (1995) Food and Nutrition: Customs and culture, London:
Chapman & Hall
80 National Food Alliance (1993) Get Cooking!, London: National Food
Alliance, Department of Health & BBC Good Food
81 Stitt, S, Jepson, M, Paulson-Box, E and Prisk, E (1997) ‘Schooling for
Capitalism: Cooking and the National Curriculum’: in Köhler, BM,
Feichtinger, E, Barlösius, E and Dowler, E (eds) Poverty and Food In
Welfare Societies, Berlin: WZB
82 Lang, T (1998) ‘Towards a food democracy’, in Griffiths, S (ed)
Consuming Passions, Manchester: Manchester University Press.
pp13–24
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83 Fieldhouse, P (1995) Food and Nutrition: Customs and culture, London:

Chapman & Hall
84 Food and Drink Federation (2000) ‘Out and about’, Feedback, 36,
summer, 8
85 Jakle, JA and Sculle, KA (1999) Fast Food: Roadside Restaurants in the
Automobile Age, Baltimore: Johns Hopkins Press
86 Murcott, A (1995) ‘It’s such a pleasure to cook for him’: food, meal-
times and gender in some South Wales households: in Jackson, S
and Moores, S (eds) The Politics of Domestic Consumption, Hemel
Hempstead, UK: Prentice Hall/Harvester Wheatsheaf
87 Gershuny, J and Fisher, K (2000) ‘Leisure’: in Halsey, AH with
Webb, J (eds) Twentieth-Century British Social Trends, Basingstoke,
Hampshire: Macmillan, pp620–649
88 Reisig, VMT and Hobbiss, A (2000) ‘Food deserts and how to tackle
them: a study from one city’s approach’, Health Education Journal, 59
(2), pp137–149
89 Robinson, N, Caraher, M and Lang, T (2000) ‘Access to shops; the
views of low income shoppers’, Health Education Journal, 59 (2),
pp121–136
90 Trager, J (1995) The Food Chronology, New York: Henry Holt & Co.
p167
91 Raven, H and Lang, T (1995) Off our Trolleys?: food retailing and the
hypermarket revolution, London: Institute of Public Policy Research
92 Department of Health (1996) Low Income, Food, Nutrition and Health:
Strategies for Improvement: Report by the Low Income Project Team for
the Nutrition Taskforce, London: Department of Health
93 Dowler, E, Blair, A, Donkin, A, Rex, D and Grundy, C (2001)
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94 Raghavan, C (1990) Recolonisation: GATT, the Uruguay Round and the
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95 Starr, A (2000) Naming the enemy: anti-corporate movements confront
globalization, London: Zed and Pluto
96 Burbach, R (2001) Globalization and postmodern politics, London: Pluto
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98 Millstone, E (1991) ‘How to involve consumer organisations in
the agricultural policy and international relations debate’, Paper
to conference: ‘Comment Nourrir Le Monde? Les politiques
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99 Smith, NC (1990) Morality and the market: consumer pressure for
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338 FOOD WARS

100 Witowski, TH (1989) ‘Colonial consumers in revolt: buyer values

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101 Allain, A (1991) ‘Breastfeeding is politics: a personal view of the
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food complex’, International Journal of Sociology of Agriculture and
Food, 1, pp126–142
2 Bonnano, A and Constance, DH (2001) ‘Corporate strategies in the
Global Era: The Case of mega-Hog Farms in the Texas Panhandle
region’, International Journal of Sociology of Agriculture and Food, 9,
pp5–28
3 Goodman, D and Watts, M (eds) (1997) Globalising Food: Agrarian
Questions and Global Restructuring, London: Routledge
4 Burch, D, Lawrence, G and Goss, J (1999) Restructuring Global and
Regional Agricultures: Transformation in Australasian Economies and
Spaces, Aldershot, Hants: Avebury
5 Raynolds, LT (2000) ‘Re-embedding Global Agriculture: the Inter-
national Organic and Fair Trade Movements’, Journal of Agriculture
and Human Values, 17, 3, pp297–309
6 Draper, P (ed) (1991) Health through Public Policy: the greening of public
health, London: Greenprint
7 McMichael, AJ (2001) Human Frontiers, Environments and Disease,
Cambridge: Cambridge University Press
8 McMichael, AJ (1999) ‘From Hazard to Habitat: Rethinking Environ-
ment and Health’, Epidemiology, 10, 4, pp1–5
9 Lang, T, Barling, D and Caraher, M (2001) ‘Food, Social Policy and
the Environment: Towards a New Model’, Social Policy and Adminis-
tration, 35, 5, pp538–558
10 Meadows, DH, Meadows, DL, Randers, J and Behrens, W (1972) The
Limits to Growth, London: Earth Island
11 Goldsmith, E, Allen, R, Allaby, M, Davoll, J and Lawrence, S (1972)
‘Blueprint for Survival’, The Ecologist, 2, 1, pp1–43
12 Carson, R (1962) Silent Spring, Boston: Houghton Mifflin Co
13 Lovelock, J (1979) Gaia: a new look at life on earth, Oxford: Oxford
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14 UNDP (1998) World Development Report, quoted in UNEP (2002)
Global Environment Outlook 3. London: Earthscan/UNEP, p35
15 Durning, AT (1992) How much is enough? London: Earthscan
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16 Brown, LR (1996) Tough Choices: facing the challenge of food scarcity,

London: Earthscan
17 Dyson, T (1996) Population and Food: global trends and future prospects,
London: Routledge
18 Ehrlich, PR, Ehrlich, AH and Daily, GC (1995) The Stork and the
Plough, New York: Putnam Press
19 FAO Agriculture: Towards 2015/2030, technical interim report April
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21 Boyd Orr, J (1943) Food and the People, Targets for Tomorrow 3,
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22 Mackintosh, J (1944) The Nation’s Health, Targets for Tomorrow 4,
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23 Goodman, D, Sorj, B and Wilkinson, J (1987) From Farming to Bio-
technology, Oxford: Blackwell
24 Carson, R (1962) Silent Spring, Boston: Houghton Mifflin Co
25 Lang, T and Clutterbuck, C (1993) P is for Pesticides, London: Ebury
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27 McGinn, AP (2000) ‘Phasing out Persistent Organic Pollutants’, in
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29 McKee, M (1999) ‘Trust me, I’m an expert’, European Journal of Public
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30 Mackenzie, D (1999) ‘Recipe for disaster’, New Scientist, 12 June
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CHAPTER 7
1 Richards, D and Smith, M (2002) Governance and Public Policy in the
United Kingdom, Oxford: Oxford University Press
2 Wallace, H and Wallace, W (2000) Policy-making in the European Union,
4th edition, Oxford: Oxford University Press
350 FOOD WARS

3 Deacon, B, Ollila, E, Koivusalo, M and Stubbs, P (2003) Global Social

Governance, Globalism and Social Policy Programme, Helsinki:
STAKES
4 World Resources Institute (2003) World Resources 2002–2004, Wash-
ington D.C.: World Resources Institute
5 Nestle, M (2002) Food Politics, Berkeley: University of California
Press
6 Sims, L (1999) The Politics of Fat: food and nutrition policy in America,
New York: M E Sharpe Inc
7 Cannon, G (1987) The Politics of Food, London: Century
8 For example, Alliance for People’s Action on Nutrition (2003) Founding
Document, Chennai, India, APAN March, http://www.apanutrition.
org
9 Vidal, J (1997) McLibel: burger culture on trial, London: Pan
10 Lamont, J (2002) ‘Big oil groups top league for ‘greenwash’, Financial
Times, 25 August, p2
11 Cockett, R (1995) Thinking the Unthinkable: think-tanks and the econ-
omic counter-revolution 1931–1983, London: HarperCollins
12 UN Committee on Economic, Social and Cultural Rights (1999)
Substantive Issues arising in the Implementation of the International
Covenant on Economic, Social and Cultural Rights: General Comment 12:
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49 Lang, T and Rayner, G (2003) ‘Food and Health Strategy in the UK:
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54 OECD, PSE/CSE database 2002
55 US Department of Agriculture, cited in the in the Financial Times,
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57 Action Aid (2003) Farmgate: The developmental impact of agricultural

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72 Puska, P, Tuomilehto, J, Nissinen, A and Vartiainen, E (eds) (1995)

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76 Vail, D (1994) ‘Sweden’s 1990 Food Policy Reform’, in McMichael, P
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81 EASA (1995) Survey on self-regulation for advertising and children in
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for Ecology and Culture

CHAPTER 8
1 Brunner, E, Rayner, M, Thorogood, M, Margetts, B, Hooper, L et al
(2001) ‘Making public health nutrition relevant to evidence-based
action’, Public Health Nutrition, 4 (6), pp1297–1299
2 See, for example, Eric Hobsbawm’s magisterial historical reviews in
The Age of Revolution, The Age of Capital, The Age of Empire and The Age
of Extremes
3 Commission on Macroeconomics and Health (2001) Macroeconomics
and Health: Investing in health for economic development, Report to the
World Health Organization from the Commission on Macroecon-
omics and Health, Geneva: World Health Organization, http://
www.cid.harvard.edu/cidcmh/CMHReport.pdf
4 Millstone, E and Lang, T (eds) (2003) Atlas of Food, London: Earthscan/
New York: Penguin
356 FOOD WARS

5 von Clausewitz, C (1976 [1832]) On War, Howard, M and Paret, P (ed

and trans). Princeton: Princeton University Press, p87
6 Millstone, E and van Zwnaenberg, PF (2000) ‘Food safety and
consumer protection in a globalised economy’, Swiss Political Science
Review, 6, 3, pp109–118
7 Buck, T (2003) ‘EU “obeys WTO ban on beef hormones”’, Financial
Times, 16 October
8 Esserman, S and Howse, R (2003) ‘The WTO on trial’, Foreign Affairs,
82, 1, pp130–140
9 Elinder, L (2003) Public Health Aspects of the EU Common Agricultural
Policy, Stockholm: National Institute of Public Health, http://www.
fhi.se/shop/material_pdf/eu_inlaga.pdf
10 Popkin, BM and Nielsen, J (2003) ‘The Sweetening of the World’s
Diet’, Obesity Research, 11, 11, pp1–8
11 For example, Hume Hall, R (1974) Food for Nought: the decline in
nutrition, New York: Harper and Row
12 For example, Lerza, C and Jacobson, M (eds) (1975) Food for People
not for Profit: a sourcebook on the Food Crisis, New York: Ballantine.
13 George, S (1976) How the Other Half Dies, Harmondsworth: Penguin
14 Robbins, P (2003) Stolen Fruit: the tropical commodities disaster,
London: Zed Press
15 Lang, T (1996) ‘Going public: food campaigns during the 1980s and
1990s’, in Smith, D (ed) (1996) Nutrition Scientists and Nutrition Policy
in the 20th Century, London: Routledge, pp238–260
16 Altieri, M (1996) Agroecology: the science of sustainable agriculture,
Boulder: Westview Press
17 Pretty, J (2002) AgriCulture, London: Earthscan
18 Pretty, J and Hine, R (2001) Reducing Food Poverty with Sustainable
Agriculture: A Summary of New Evidence, Final Report of the SAFE-
World Research Project, February, Colchester: University of Essex
19 Funes, F, Garcia, L, Bourque, M, Perez, N and Rosset, P (2002)
Sustainable Agriculture and Resistance: Transforming Food Production
in Cuba, Oakland CA: Food First Books
20 http://ns.rds.org.hn/via/
21 http://www.sustainweb.org
22 http://www.ibase.org.br/
23 http://vshiva.net
24 Furusawa, K (1994) ‘Co-operative alternatives in Japan’, in Conford,
P (ed) A Future for the Land, Bideford: Resurgence Books
25 Burlton, B (2000) Presidential Address 2000 to Co-operative Congress,
Manchester: Co-operative Congress
26 http://www.slowfood.com
27 Jackle, JJ and Scully, KA (1999) Fast Food: Roadside Restaurants in the
Automobile Age, Baltimore: the Johns Hopkins University Press
 NOTES AND REFERENCES 357

28 Elliot, L (2003) ‘Cleaning Agent: Interview with Niall Fitzgerald’, The

Guardian, 5 July
29 Boyle, D (2003) Authenticity: brands, fakes, spin and the lust for real life,
London: Flamingo
30 Norberg-Hodge, H, Goering, P and Page, J (2001) From the Ground
Up: Rethinking Industrial Agriculture, London: Zed
31 McDonald’s (2003) Global Policy on Antibiotics in Food Animals, Policy
statement, 19 June 2003. Chicago Ill: McDonalds Corporation, http:/
/www.mcdonalds.com/corporate/social
32 Dinham, B and Hines, C (1982) Agribusiness in Africa, London: Earth
Resources Research
33 Barratt Brown, M (1993) Fair Trade, London: Pluto
34 Fairtrade Foundation, http://www.fairtrade.org.uk/
35 Coote, B (1992) The Trade Trap: poverty and the global commodity
markets, Oxford: Oxfam publications
36 ‘Race to the top’ project, coordinated by International Institute for
Environment and Development. www.racetothetop.org
37 Raven, H and Lang, T (1995) Off our Trollies? London: Institute for
Public Policy Research
38 ‘IFAP adopts NFU proposals attacking industrial concentration in
Agriculture’, Agribusiness Examiner, 16 May 2003, issue 248
39 Eurepgap, the global partnership for standards on fresh produce
and flowers. See: http://www.eurep.org/sites/index_e.html
40 Nestle, M (2002) Food Politics, Berkeley: University of California
Press
41 Maxwell, S and Slater, R (eds) (2003) ‘Themed Issue: Food Policy Old
and New’, Development Policy Review, 21, Nos 5–6, September–
November, pp531–710
358 FOOD WARS

INDEX
acrylamide 221 Australia, food agency 278
activism 210–12, 262–3, 293–4 Australian Consumers’ Association
advertising 210
and education 198–203
and obesity 203–7 bacterial infections 87–8, 89
to children 205–7 bananas, supply chain 151–2
Africa Bangladesh, urbanization 232
coronary heart disease (CHD) 80 Barker, David 84
diet 131 Barrett, H 152
diseases 55–6 Baudrillard, Jean 191–2
agencies, food policy 277–9 Belgium, dioxin contamination 220
agrarian political economy 142–4 biochemistry, and food industry 104
agribusiness 147–51 biodiversity 221–3, 255
agriculture biotechnology
biodiversity loss 221–3 and Life Sciences Integrated
competition policy 299–300 paradigm 21–6
farming implications 147–51 in 21st century 21, 178–9
and food production 137–8 body image 189
and food supply chain 15 body mass index (BMI) 64
ghost acres 241–2 Borgstrom, George 241
industrialization 139 Boyd Orr, John 94, 107
intensification 219–21 brand marketing 156, 199
monoculture 148–9 Brazil, food activism 210
organic production 174–8 Brown, Lester 135–6
prehistoric 254 Brundtland, Gro-Harlem 48
and public health 107–8 BSE (bovine spongiform
public policy 133 encephalopathy) 40–1, 135, 220
subsidies 271–5 Burger King 124, 170
sustainable 294–5 ‘burgerization’ 42, 60, 191–2
urban 232–3 Burkitt, D 55–6
water use 224 Bush, George W 66
see also GM foods
agroecology 27–8, 294–5 Campylobacter 87
Ahold 163 Canada
American Council for Fitness and farmers 150
Nutrition 212 food activism 210
antibiotics 248–50 cancer
aquaculture 244, 245, 247 causes of 49
Atwater, W O 105 diet-related 80–1, 82–3
 INDEX 359

Cancun trade negotiations (2003) consumption, and food supply chain

266–7, 289 15
Carrefour 163, 164 cooking, and food culture 207–9
catering see food service industries cooperatives 295
Center for Consumer Freedom 212 coronary heart disease (CHD) 75–80
Chadwick, Edwin 100 corporate interests, and food supply
chemicals, health risks 219–20 chain 15–16
children corporate power, food industry 126–8
fruit consumption 250–53 corporate social responsibility 297–8
malnutrition 90–1 Council for Biotechnology
marketing to 204–7 Information 198
obesity 66, 67–8, 172, 204–5 Crawford, Michael 255
China Cuba
coronary heart disease (CHD) 80 agroecology 27, 294–5
food exports 152–3 urban agriculture 233
nutrition transition 56, 57, 58–9
supermarkets 163 Daft, Douglas 158–9
urbanization 232 Dalmeny, Kath 206
civil society DALY (disability adjusted life year)
governance 262–3 71–3
and paradigms of food supply Danone 204
293–300 deaths
climate change 230–1 causes of 54, 55
Coca-Cola 158–9, 185 coronary heart disease (CHD) 77–9
Cochrane Collaboration 43–4 diet-related 42–3, 70
Codex Alimentarius Commission Denmark, food agency 278
267–9 desertification 230
Commission on Macroeconomics and developed countries
Health 73–5 diet 130, 132
Competition Commission, food farmers 148–51
retailing 165–6 food poverty 95–6
competition policy 299–300 developing countries
ConAgra 144, 147, 153 diet 130–1, 132
Consumer Union and Trust Societies diseases 53, 56
(CUTS) 210 food supply chain 151–2
consumerism, competing models obesity 64–66
192–4 supermarkets 163–4
consumers diabetes 72, 81–5
aspirations of 194–7 diet
and choice 280–1 and cancer 80–1, 82–3
and environmental health 216, and coronary heart disease (CHD)
218–19 77–80
and food activism 210–12 and diseases 48–53, 56, 73
and food culture 184–6, 195 and economic development 130–1,
health active 186–7 132
resistance from 189 fish consumption 246–7
responsibilities of 304 fruit and vegetables 112–113,
role of 191–2 250–54
targeting of 41–2 and genetics 23–4
360 FOOD WARS

and health 36, 186–8, 254–6 climate change 230–1

and mortality 42–3 and consumers 218–19
nutrition transition 53–60 energy and efficiency 233–42
Western diet 115–17 fishing 136–7, 242–7
dietary guidelines and food policy 43, 214–17
Eurodiet 116 health impacts 225–7, 254–6
and food supply chain 117–20 and intensification 219–21
nutrition policy 302–3 meat production 248
public health 111–13, 285 pesticides and pollution 225–7
United States 113–14 soil erosion 229–30
dioxins 220 waste 228–9
diseases water resources 224–5
costs of 71–85 ethnic foods 195
diet-related 48–53, 56, 73 Eurepgap system 301
financial costs 73–7 European Food Safety Authority
food-borne 85–8 (EFSA) 278
obesity-related 69–70 European Union (EU)
types of 53, 56 Common Agricultural Policy
see also health (CAP) 18, 151, 178, 269–71
Dyson, Tim 136 diet 130, 186–7
Eurodiet 116
E. coli 86, 87 food industry 155
ecological footprint 241 food retailing 160–3
ecological issues organic farming 176–7
food production 135–7 evidence, and food policy 42–6
GM crops 180–1
see also environment Fair Trade movement 298
ecological nutrition 5–6, 254 farmers
ecological public health 102 and agribusiness 147–51
Ecologically Integrated paradigm see also agriculture
comparison with other paradigms fast food 170–3, 208–9
28–9, 285–9 Fiji, urbanization 232
features of 21, 26–8, 32 Finland, food policy 276, 277
food and health policy 286–7 Fischler, Franz 133, 178
future of 307 fishing, ecological issues 136–7,
and health 37–40, 119 242–7
and organic production 174 Fitzgerald, Niall 296
see also paradigms of food supply Food and Agriculture Organization
education (FAO), integrated nutrition
and advertising 198–203 policy 118
healthy eating 112, 250–54 food commodities, globalization
efficient consumer response (ECR) 190–2
216 food control 279–80
Egger, Garry 70 food culture 185–6, 195
energy use, food industry 233–42 and cooking 207–9
environment and food industry 197–8
and antibiotic use 248–50 models of 192–4
biodiversity loss 221–3 food democracy 279–80, 295
 INDEX 361

food energy, global distribution food retailing

52–3 competition 165–6, 299
food industry global consolidation 160–4
advertising 198–203 hypermarkets 209–10
company clusters 144–7 suppliers 164–7
company cultures 157–60 food safety 85–8, 89, 216–17, 267–9
corporate power 126–8 Food Science Australia 188
energy use 233–42 food security 92–4
environmental audits 298–9 food service industries 167–73
and food culture 197–8 food shopping 209–10
global companies 153–5 Food Standards Agency (FSA) 175,
global issues 135–7 178
growth of 128–33 food supply chain
nutraceuticals 134–5 added value 143
and obesity 123–5 characteristics 15–16
structural change 155–6 company clusters 144–7
food justice movements 295 and environment 216
food miles 235–40, 295 industrialization 139–41
food policy and nutrition policy 108–9,
agencies 277–9 117–20
choices 13–14 stages of 14
and diet-related disease 96–7, see also paradigms of food supply
99–100 Food Wars
evidence-based 42–6 definition 12
future options 300–7 future policy options 301–7
global commitments 263–5 paradigm conflicts 17–18, 284–9
global institutions 265–7 and propaganda 40–1
governance 258–61 Friends of the Earth 262
national interventions 275–9 fruit, consumption of 113, 250–54
and paradigms of food supply
283–4 G-21 group 266–7, 289
see also nutrition policy Galileo Laboratories Inc 23
food poverty General Agreement on Tariffs and
developed countries 95–6 Trade (GATT) 190, 265–7
inequalities 89–91 genetics see GM foods; nutrigenomics
food processing ghost acres 241–2
company clusters 144–7 Gilbert, Linda 187
global companies 153–9 global commitments, food policy
food production 263–5
and agriculture 137–8 Global Forum on Sustainable Food
biodiversity loss 221–3 and Nutritional Security 210
ecological issues 135–7 global institutions
and environment 214–17 food governance 258–61
ghost acres 241–2 food policy 265–7
global standards 267–9 global issues, food industry 135–7
intensification 220–22 global standards, food safety 267–9
pesticide pollution 225–7 global warming 230–1
urban areas 232–3 globalization, of food 190–2
362 FOOD WARS

GM foods hydroponic production 215

and consumer choice 30–3 hypermarkets 209–10
labelling of 202
in Life Sciences Integrated IBASE (Instituto Brasil rode Análises
paradigm 22–3, 25 Sociais e Econômicas) 210
marketing of 197–8 Ilbery, B W 152
political issues 173–4, 178–82 immigrants, and food culture 195
governance income, and diet 53–60
civil society 262–3 India
and consumer choice 280–1 diabetes 81, 84
food agencies 277–9 food activism 210
food democracy or control 279–80 individual freedom 280–1
food policy 258–61 industrialization, and public health
future issues 301–7 100
global institutions 265–7 inequality, food poverty 89–91
Greece, coronary heart disease integrated pest management (IPM)
(CHD) 78 175
Green Revolution, health issues 36 intensification 219–21
greenhouse gases 230–1 International Agency for Research on
Greenpeace 262 Cancer (IARC) 49
Gussow, Joan 26 International Association of
Consumer Food Organizations
Hamel, Gary 6 (IACFO) 206
Hazards Analysis Critical Control International Association for the
Point (HACCP) 86–7 Study of Obesity (IASO) 49, 63
health International Baby Food Action
and antibiotics 248–50 Network (IBFAN) 262
conceptions of 100–1 International Food and Agribusiness
consumer awareness 186–8 Management Association 197–8
and diet 36, 186–8, 254–6 International Food Policy Research
and food industry 134–5 Institute (IFPRI) 138, 248
and food policy 275–9 international organizations, food
food safety issues 85–8 governance 258–61
and food supply chain 16 International Treaty for Plant Genetic
and marketing 41–2 Resources for Agriculture 223
and paradigms of food supply iodine deficiency 91
34–40 irradiated foods, labelling of 202
and pesticides 225–7 irrigation 225
see also diseases; public health
health care, costs 73–7 Kellogg 160
HealthFocus 187 Kenya, food exports 152
heart disease see coronary heart Keys, Ancel 108, 115
disease Kraft 124, 160, 207
Heffernan, W 144, 147 Kuhn, Thomas 17, 33
hierarchy of needs 196–7 Kunast, Renate 132–3
Hopkins, Frederick Gowland 104,
105 labelling, of food 202–3, 275
hormones 289 Latin America, diet 130
 INDEX 363

lettuce, production methods 215 migration, rural–urban 231–3

Life Sciences Integrated paradigm Miller, Guy 23
comparison with other paradigms Monsanto 25, 26
28–9, 285–9 morbidity, diet-related 43, 71–2
and diet 254 mortality see deaths
features of 21–6, 31 mothers, nutrition of 61–2
food and health policy 286–7 MRSA (Methicillen-resistant
future of 307 staphylococcus aureus) 249
and health 37–40, 119 Murray, C J L 71–2
see also paradigms of food supply
Lind, James 103–4 Nabisco 160
Listeria monocytogenes 86–8 National Food and Nutrition Action
livestock see meat Plans 302
localization 158–9, 296 Nestlé
London, ghost acres 241 boycott of 212
Lopez A D 71–2 food sales 153
history 157–8
Malaysia, food activism 211 nutrition policy 6
malnutrition obesity response 124
children 90–1 Nestle, Marion 115, 140
types of 60–1 New Zealand
under-nourishment 60–3 agricultural subsidies 272
see also obesity food agency 278
marketing NGOs (non-governmental
and health 41–2 organizations) 210–12, 262–3,
and obesity 203–7 293–4
Martin, Marshall 137–8 Norway
Martorell, R 102–3 dietary guidelines 114
Maslow, Abraham 196 food agencies 278
Mauritius, obesity 66 food policy 275–6
Maxwell, S 92 nutraceuticals 134–5, 198
McCarrison, Robert 106–7 nutrigenomics 23–4
McDonalds nutrition labelling 203, 275
antibiotics ban 250 nutrition needs 222
corporate social responsibility nutrition policy
297 dietary guidelines 111–13, 285,
and food activism 263 302–3
‘global going local’ strategy 199, integrated approach 117–20
202 and obesity 120–2
growth of 170, 171–2 and social policy 103–9
obesity response 124 see also food policy
McMichael, A J 249 nutrition sciences 6
meat nutrition transition 53–60
antibiotic use 250
demand for 138 obesity
production methods 220–21, 248 children 66, 67–8, 172, 204–5
Mediterranean diet 108 environmental factors 70
Middle East, nutrition transition 58 and food industry 122–5
364 FOOD WARS

future policy 300 Productionist paradigm

health risks 43, 69–70 comparison with other paradigms
increasing 49, 63–70 28–9, 285–9
and marketing 203–7 failure of 44
public policy responses 120–2 features of 18–20, 29, 290–2
organic production 173, 174–8, 242 food and health policy 286–7
Organisation for Economic and health 34–7, 47, 50
Co-operation and Development see also paradigms of food supply
(OECD), agricultural subsidies proximity principle 296
272–3 public health
conceptions of 100–3
packaging, waste 228–9 dietary guidelines 111–13
paradigms of food supply 12–13, and ecology 256
16–28 environmental hazards 216–18
and agribusiness 153 food safety 86–8, 89, 216–17
and biotechnology 173–4 future policy 303
and civil society 293–300 individual or population focus 119
and Common Agricultural Policy and intensification 219–21
271 national policies 275–9
comparisons 28–30, 285–9 nutrition policy 103–6, 117–20
conflicts 30–4 and obesity 120–2
corporate power 127–8, 129 targeting 109–11
and food culture 186 see also health
and food industry 132–3
and food policy 283–4 Race to the Top project 299
food retailing 167 radical options 5–8
future policies 307 Reardon, Tom 163
and health issues 34–40 recommended dietary allowances
Perry, Michael 199 (RDAs) 112
persistent organic pollutants (POPs) recycling, of waste 228–9
225–7, 246 Research Insitute for Science,
pesticides, health risks 219, 225–7 Technology and Ecology 210
Philip Morris, food sales 153 retailing see food retailing
Philippines, urbanization 232 Robertson, James 26
pollution Rose, Geoffrey 111
and fishing 244 Rowe, David 197–8
pesticides 225–7 Rowett Research Institute 107
of water 224 Rowntree, B Seebohm 105
Popkin, Barry 53–5, 56–7 rural population, diets 56–8
potatoes
biodiversity loss 222 Salmonella 86–8, 249
history of 190 Scandinavia, food policy 275–7
poverty Scrimshaw, Nevin 115
food poverty 95–6 scurvy 104
food supply 89–91 Shapiro, Bob 25
and nutrition policy 107 shopping 209–10
producer support estimate (PSE) Sinclair, Hugh 108
272–3 slow food 189, 296
 INDEX 365

social policy, nutrition 103–9 agricultural subsidies 272, 274

soil erosion 229–30 diet 130
Starbucks 297 dietary guidelines 113–14
subsidies, agricultural 271–5 farmers 148–9
sugar, globalization 190 fast food 208–9
supermarkets 163–4, 165–7, 209–10, food clusters 144–7
281 food labelling 275
sustainable agriculture 294–5 food poverty 95–6
Sweden, food policy 276–7 food supply 140
Swinburn, Boyd 70 obesity 68–9, 123
urban population, diets 56–8,
television, cookery programmes 231–3
207–8 urbanization 231–3
Tesco 163
Thailand, diabetes 84 Vavilov centers 190
Thatcher, Margaret 101 vegetables, consumption of 250–54
Third World Network 211 vitamins 104
Toronto Food Policy Council 210 Vorley, Bill 160
trade
Fair Trade movement 298 Wal-Mart 160, 163, 165
global institutions 265–6 Wanless, Derek 75–7
transport, food industry 237–42 waste 228–9
Trowell, H 55–6, 80 water
bottled 194
Unilever 159, 185, 298 demand for 224–5
United Kingdom Western diet 115–17
advertising 200–1 wheat, globalization 190–1
agricultural subsidies 272–4 Wittgenstein, Ludwig 17
agriculture 133 women, nutrition of 61–2
consumer NGOs 211 Wood, T B 105
fish consumption 246–7 World Food Summit (2002) 302
food chain 141–2, 143 World Health Organization
food costs 241–2, 243 (WHO)
food culture 209 diet and health strategy 48–9
food poverty 95 global standards 269
food retailing 165–7 integrated nutrition policy 118
Food Standards Agency 278 and obesity 63–4, 204–5
fruit and vegetable consumption public health definition 102
250–54 World Trade Organization (WTO)
health care costs 75–7 265–6, 267–9, 289
obesity 121 World Wide Fund for Nature (WWF)
organic foods 175, 178 262
United Nations, Millennium
Development goals 90–1 Yum! Brands 170, 171
United States
advertising 202 zero-till (ZT) agriculture 174