So five a day does not keep the doctor away. Or at least not the cancer specialist.
New research from Mount Sinai School of Medicine, in New York, claims that the findings from research conducted into the eating and health habits of 470,000 people in Europe (including the UK) produces no evidence that the government-backed effort, supported by many protection insurers, via the five a day campaign to increase consumption of fruits and vegetables has any substantial effect on cancer incidence.
At best, the fruit eaters and the vegetable chompers only reduce the odds of contracting a cancer by around 3%. This contradicts the received wisdom of the past two decades – it was a World Health Organisation report which started the five a day movement. It could also be uncomfortable for insurers who have based some protection product marketing and pricing around the five a day concept.
Cue the tabloids going into a frenzy of “I told you so” comments. The findings, which contradict the original and much subsequent research are grist to the media mill. The Mount Sinai figures can be hailed as “victory against nanny-statism” and “a new blow in the fight for commonsense”.
And cue also journalists calling up the press offices of health and other protection insurers to ask where this leaves discounts for healthy lifestyles. If eating your greens and crunching your apples has such a marginal effect why do those who sign up for this gain substantial discounts with a number of firms?
By now, this story has appeared in thousands of media outlets and has probably been tweeted and re-tweeted a few million times. One headline came up with “Boffins call for meat and two drinks diet”. What, only two drinks?
It appears that the retreat from the original conclusion that five a day reduced the risks of some cancers came because the original research skewed the results by relying on the healthier section of the population with a propensity to eating fruit and vegetables (rather than deep-fried pizza slices) for its answers. People who volunteer for surveys tend to be wealthier, fitter, happier and don’t get ill so often. People who don’t fill in surveys often refuse because they have a poor lifestyle with bad eating habits. And they don’t want to admit this.
But it would be wrong if this story gave the green light to a return to a permanent diet of all day breakfasts (with an extra portion of chips) washed down with strong cider.
The articles are all silent on which organisations paid for the Mount Sinai research. Given the huge cohort and the length of time, the cost must have had many figures after the dollar sign. While it may not have been the Greasy Spoon Association of America, all diet research comes with the caveat that if you don’t know the sponsor, you don’t know nothing. The tobacco industry spent billions over the years financing research designed to minimise, if not deny, the correlation between smoking and lung cancer. Likewise, the links between sugar, salt, animal fats and poor health have been denied time after time by sponsored research.
But all is not lost for underwriters and marketers pushing the five a day message. For buried in some articles and ignored in many others is the admission from the Mount Sinai research that the five a day campaign has a significant role to play in reducing heart disease and strokes. That’s well worth eating your salad leaves for.
Equally missed out is the displacement effect. If I eat loads of fruit and vegetables, then I eat less bad foods. It is very simple. We all have to consume food. And we all want to feel satisfied. As an underwriter, which would I prefer? The five fruit and veg a day person or the five battered Mars bar person?
Now can the tabloids and the bloggers really say we are better off with burgers and chemically produced crisps to deal with our hunger than with more apples and artichokes?
This can hardly be the message that the protection insurance world wants customers to receive. What if the original underwriting was on the basis of a healthy diet and the insured read the stuff about five a day and reverted to a pizza and chips?
So did the industry do anything to rebut the Mount Sinai articles? After all, when there’s some obscure move on the Retail Distribution Review, the press offices of our leading insurers go into overdrive.
I could not find anything on the day of the articles or the next. No insurer seems willing to speak up for healthy eating despite the Mount Sinai admission that five a day prevents heart disease and strokes although the World Cancer Research Fund did rebut some points.
Oddly, Aviva had just days before it announced it had become the first insurer to sign up to Change4Life, the Department of Health’s good diet initiative through its MyHealthCounts service which helps people take simple steps to lead a healthy lifestyle.
Aviva says it will now be supporting the new Change4Life “swap it, don’t stop it” message, promoting eating and physical activity behaviour changes. Aviva adds: “This fits our ambitions to not only provide products to support customer’s health, but to positively change people’s behaviours and attitudes to health.” MyHealthCounts contains information including a health assessment tool and an online coach offering personalised advice on the simple steps individuals can take to improve their health.
But even if insurers are not willing to take on a major American research hospital, they could at least try promoting a healthy diet with a “save the planet” message.
Eating more fruit and vegetables and less meat is good for the environment and good for economic wellbeing. This is not the forum to make the case. But insurers should go to the website of UK charity Compassion in World Farming (don’t worry, carnivores, it’s not vegan or vegetarian) which has substantial research. Compassion in World Farming does not normally accept donations from corporates as it fears compromise by the food industry. It might, however, make an exception for insurers.