Aseem Malhotra is a man on mission. As a campaigner and founding member of the organisation Action on Sugar, set up two years ago by a group of doctors and researchers to publicise the harmful effects of junk food and a high-sugar diet, the 38-year-old cardiologist has certainly been making waves.
“One of the things I’ve been trying to do is raise awareness through getting messages into the mainstream media which I know has an impact on the public, he says of his approach.
Now with a new website, blog and crowdfunded documentary on healthy eating in the pipeline, Malhotra is stepping up his campaigning efforts.
The son of two GPs from Greater Manchester (his father is Kailash Chand, deputy chair of the British Medical Association), Malhotra is part of a growing push to prioritise curbs on excess sugar consumption, which is increasingly seen as a major contributor to obesity and related illnesses. And the stakes are very high indeed, he says.
Health conditions related to obesity have surged across the world. According to the World Health Organisation, 13% of the global population is overweight or obese and the proportion is rising. The estimated annual cost of obesity to the NHS (67% of men and 57% of women in the UK are currently either overweight or obese) is approximately £5bn. Malhotra warns that if something isn’t done about sugar consumption, and fast, the rapid rise in chronic health conditions related to obesity and diet will have devastating consequences. “Take type 2 diabetes, which is almost entirely preventable,” he says. “The combined cost of type 2 diabetes to the economy and NHS is around £20bn per year.”
Raising awareness is vital, he says, because without pressure from the public for change, concerted government action to address the public health and cost implications is unlikely, and the outcome will be an NHS on its knees. “The increase in demand in the NHS – the fact that the NHS is under a lot of pressure – it’s heading toward bankruptcy unless we sort this out,” he says. “And it’s getting worse. There are no signs yet of any improvement.”
One of Action on Sugar’s strategies has been to try to persuade the food industry to gradually reduce the sugar it adds to food by 40% over four years. “According to the Department of Health, that would be enough to halt, and potentially reverse, the obesity epidemic,” Malhotra says. However he is under no illusions about it happening. “The reason we haven’t had the kind of improvement [needed] is that you need government intervention. You need a regulatory approach. Until that happens the situation is only going to get worse.”
If there was genuine political will, then positive changes could be brought about very quickly, he argues. Much like the ban on smoking in public places, clear, practical policy steps could have a tangible impact on people’s health right away – and on demand for healthcare, he suggests. Public education about the risks of sugar on its own will not suffice.
A “sugar tax” on fizzy drinks, advocated by numerous medical organisations, health charities and high-profile campaigners including the chef Jamie Oliver, and urged last month in a report from Public Health England, would be a good place to begin, he says. “A reduction in sugary drink consumption by about 15% – which would happen if we had a 20% tax on sugary drinks – would, within one year, prevent 180,000 people from becoming obese.”
Cracking down on marketing to children, and improved food labelling, so consumers are not misled by “fat-free” options that are laced with sugar, would also make a difference. And to the rhetoric about “personal responsibility” or attempting to heap blame purely on individuals for their own ill health or for being overweight, Malhotra gives short shrift. Yes, encourage people to eat and live more healthily, he says, but understand also that vast sums of money are poured into lobbying by the food industry. If unhealthy options are widespread and if the public is ill-informed about ingredients, then “choice” isn’t as straightforward as it might seem. “The reality is our environments and our circumstances have a much bigger impact on behaviour than we appreciate. How can anyone argue personal responsibility, if you are living in an area where you haven’t got access to healthy food? That’s just nonsensical. I think it’s criminal.”
When it comes to NHS reform, Malhotra believes the last Labour government’s “greatest legacy” was introducing the smoking ban, but is uncompromisingly scathing about the coalition and, now, the Tory government. Their record on public health is “disastrous” he says, while their reforms and restructuring are profoundly flawed, as the potential strike by junior doctors shows.
“I can’t think of a single thing this government is doing right in relation to the NHS.” As for the coalition’s 2012 Health and Social Care Act, it amounts to the “rapid and unwanted expansion of the role of commercial companies in the NHS”, he says. “This is not the system I was inspired to slog through years of medical training to work in.”
Malhotra, whose campaigning has not been without its bumpy moments including a contentious dispute about claims he made in a BMJ article as to the value of extending the use of statins to healthy people at low risk of heart disease, says he doesn’t see himself retreating to clinical practice any time soon. Inspired by his older brother’s death from heart failure, aged 13, to work in cardiology and subsequently develop a passion for preventive medicine, his motivations are more than professional.
But does Malhotra really think he can make a difference on sugar where many campaigners have tried and failed? He replies that “a combination” of actions including making the public aware “and making them angry” will help. So would more doctors speaking up. He doesn’t feel he has much choice but to keep campaigning. “It’s a duty for me now, more than anything else.”
Education Manchester grammar school; Edinburgh University medical school.
Career 2014-present: honorary consultant cardiologist, Frimley Park hospital, Surrey. 2014-2015: consultant clinical associate, the Academy of Medical Royal Colleges; 2013-2014: specialist registrar, interventional cardiology, Croydon University hospital; 2011-2013: higher specialist training as interventional cardiologist, Royal Free hospital, London; 2008-2011: specialist training as interventional cardiologist, Royal Brompton and Harefield NHS trust; 2006-2008 specialist registrar in cardiology, Royal Oldham hospital, Blackpool Victoria hospital, St James’s University hospital, Leeds; 2001-6 medical posts at Manchester Royal infirmary, The Middlesex hospital, Liberton hospital, Edinburgh, Edinburgh Royal infirmary, Wishaw general hospital, Lanarkshire.
Public life Member of Choosing Wisely steering group, Academy of Medical Royal Colleges; member, board of trustees, the King’s Fund; founding member and adviser, Action on Sugar; cardiologist adviser, National Obesity Forum; member, London Food Board.
Interests Cooking, playing guitar, watching movies, keeping fit and playing sport.
You can read the original article here: http://www.theguardian.com/society/2015/nov/18/aseem-malhotra-sugar-campaigner-prevent-obesity-public-pressure-on-government