Select Committee on Health Minutes of Evidence

Examination of Witnesses (Questions 276-279)

17 JULY 2003


  Q276  Chairman: Colleagues, may I welcome you to this session of the Committee and apologise for the slight delay in starting which is due to the fact that unfortunately a number of our witnesses are having somewhat disastrous experiences on our public transport system. We understand that Professor Blundell will not make it: he is stuck on a train between Leeds and London (which is worrying for us who are going the other way very shortly!) We understand some of the other witnesses are hopefully on their way, but we have suggested we make a start. Professor Prentice, obviously we are most grateful to you for flying the flag almost single-handedly until the others arrive.

  Professor Prentice: I am Andrew Prentice, I am Head of the Medical Research Council's International Nutrition Group at the London School of Hygiene and Tropical Medicine. I also direct the MRC's Nutrition Programme in the Gambia in West Africa.

  Dr Lobstein: I am Tim Lobstein. I am Director of the Food Commission, which is a voluntary non-governmental organisation working in the UK which is also responsible for a group called the Parents' Jury which has about 1,200 parents who vote on various food products.

  Q277  Chairman: Thank you for your contribution to this inquiry and for your written submissions which we are most grateful for. Could I begin by asking you, Professor Prentice, to say a bit about your own work. We have a copy of the paper you and Dr Jebb produced in 1995 which I think has been the basis for some quite significant debate in this whole area. I wonder if you could, by way of introduction, summarise the brief key points central to this "gluttony/sloth" debate which I know has caused some controversy. I think you feel that perhaps you have been misinterpreted.

  Professor Prentice: Indeed and hopefully I will have an opportunity to rectify that. But to step one step backwards first might be useful, which is to say that we have been supported by the MRC for many years to look at the fundamental processes of how the human body regulates body weight or why that goes wrong. We tried to look at that in a molecules-to-man direction to try to integrate the whole picture. A quick summary of many years of work at the physiological, metabolic end, is that we have come to the conclusion that the answers to this problem do not lie there, they lie within the environment. That has clearly come out of all the evidence you have had already, so I will not labour that point. With the BMJ paper in 1995 we tried to take some of that knowledge and integrate it upwards to what we know about the statistics of how the environment has changed around us and look at that as objectively as possible. It needs to be said that a lot of the evidence is very poor, so one is working within a pretty poor framework. We tried to look at that as objectively as possible.

  Q278  Chairman: You wrote this paper in 1995. Is the evidence as poor now as it was then or have some fundamental changes taken place?

  Professor Prentice: It is a great deal better now, particularly in relation to physical activity and inactivity. Twenty years ago, apart from the small amount of work done in terms of heart disease by Paffenberg, there was very little interest in physical activity. We now have that as the enormous driver of a great deal of research into the health effects of physical inactivity. That is a big change and I hope we can take a little bit of credit for driving that. The evidence at the epidemiological level is still pretty poor, but I think it is very important that we do not allow that to inhibit us from action because many of the conclusions are blindingly obvious, many of the causes of the problem are blindingly obvious. I do not think we should let certain people with perhaps vested interest be allowed to play the card that we do not yet have the evidence, we are not sure about certain things. I think it is important that, yes, we need better data but we have plenty of data to be getting on with at the moment.

  Q279  Chairman: Are you able to be more specific about people playing the card? Who are you referring to in particular?

  Professor Prentice: Certain rogue elements of the food industry. I think it is important right at the outset from my point of view to say that many aspects of the food industry are doing a fabulous job. They are providing us with a better diet and a greater choice, a wonderful variety, of healthy and low fat foods than ever before. We have a better diet than ever before. Nonetheless, there are still elements there who are fighting a rearguard action against change in the way in which we, in I think 99% of the population, would agree there needs to be change.

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