AHSNZ Wanaka Conference: Health of the Land, Health of the People

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Food Star Rating System Example Calculation – Chocolate Milk

This post relates to the star rating system that the NZ government has recently decided to support. This system will allow food manufacturers to calculate a rating (out of 5 stars) to determine the supposed ‘healthiness’ of a food. The calculations appear to be very complex, and based on some ‘interesting’ food guidelines. Below I reproduce one of the example calculations for those who are interested. This is taken directly from this document, available from this website. It does not represent my personal opinion, I really hate the idea of a star rating system – see here for more of my opinions on this.

Example 1 – Chocolate milk

Nutrition Information – chocolate milk

Component Per 100 mL
Energy 380 kJ
Protein 3.2 g
Saturated fatty acids 1.2 g
Total sugars 9.5 g
Dietary fibre 0
Sodium 45 mg
Calcium 120 mg

1) Determine the HSRC category of the food

The chocolate milk is a dairy beverage because it meets the >80 mg calcium per 200 mL reference serve requirement and is therefore a Category 1D food.

2) Determine form of food

As sold

3) Calculate HSR baseline points

Based on the nutrition information for the chocolate milk example, the baseline points obtained are highlighted below   Table 1: HSR Baseline Points for Category 1, 1D, 2 or 2D Foods*

Baseline points Average energy content (kJ) per 100 g or 100 mL Average saturated fatty acids (g) per 100 g or 100 mL Average total sugars (g) per 100 g or 100 mL Average sodium (mg) per 100 g or 100 mL
0 ≤335 ≤1.0 ≤5.0 ≤90
1 >335 >1.0 >5.0 >90
2 >670 >2.0 >9.0 >180
3 >1005 >3.0 >13.5 >270
4 >1340 >4.0 >18.0 >360
5 >1675 >5.0 >22.5 >450
6 >2010 >6.0 >27.0 >540
7 >2345 >7.0 >31.0 >630

*This table is a shortened version of Table 1 provided in the HSRC Guide above       Total baseline points=             (1) + (1) + (2) + (0) =             4

4) Calculate HSR modifying points

HSR V points The chocolate milk in this example does not contain any fvnl.   V points = 0   HSR Protein (P) and fibre (F) points Category 1D foods cannot score F points.   Based on the nutrition information for the chocolate milk example, the protein points obtained are highlighted below:   Table 4: HSR Protein (P) and Fibre (F) Points

Points Protein (g) per 100 g or 100 mL Dietary fibre (g) per 100 g or 100 mL
0 ≤1.6 ≤0.9
1 >1.6 >0.9
2 ≥3.2 >1.9
3 >4.8 >2.8
4 >6.4 >3.7
5 >8.0 >4.7
6 >9.6 >5.4
7 >11.6 >6.3
8 >13.9 >7.3
9 >16.7 >8.4
10 >20.0 >9.7
11 >24.0 >11.2
12 >28.9 >13.0
13 >34.7 >15.0
14 >41.6 >17.3
15 >50 >20.0

The foods in this example contains 3.2 g of protein per 100 ml and therefore scores 2 protein points. P points = 2 F points = 0    

5) Calculate the final HSR score

Chocolate milk   Final HSR Score          =          4 – (0) – (2) – (0) =      2

6) Assessment of the final HSR score to a rating

The final HSR score for the chocolate dairy milk example (Category 1D food) is 2. Therefore the food, for the purposes of this example only, would be assigned a rating of 3 stars.   Note: the rating of similar products may vary depending on the amount of added sugar or fibre and type of milk used.

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“Diets have never worked”: Niki Bezzant in the Sunday Star Times

“Diets have never worked” Niki Bezzant writes in the Sunday Star Times. The article is a short set of statements with three main messages:

  1. Things haven’t changed much since at least the 1960s (as evidenced by a 1966 diet book discovered at a book sale)
  2. The 1960s was a time of quaint language and odd food choices (at least by todays standards)
  3. But you can lose weight for life, but only if you:

“find a way of eating that we can live with not just for 12 weeks, but for our whole life” 

Putting aside the anecdote and hyperbole the logic perversion from beginning to end is a bit odd. Bezzant’s sense of logic appears to be completely perverted by this ‘fantasy of weight loss’. Everything she reads gets dragged into alignment with the idea that eventually everyone can and should lose weight for life, that we can all live in an (un)happy utopia hovering somewhere close to the mid point of the Body Mass Index measure. 

Discovering ancient diet books and chuckling at their peculiarities is not exactly a new thing, historians of weight loss and dieting have been making these observations for many years, see examples in this great article by Jessica Parr and Prof Nicolas Rasmussen for instance. And although the language is quaint and the food choices odd, the reality is that much has actually changed since 1966. Two things of particular note: The average New Zealander is around 8kg heavier and they also live about 15 years longer (you can figure the relationship here). 

What has also changed is the fervor with which the average weight loss focused nutritionist/dietician claims to have figured it all out. Bezzant’s final paragraph is telling: 

But the fact remains (and we have known this since before 1966) that if we want to maintain weight loss, we need to find a way of eating that we can live with not just for 12 weeks, but for our whole life. And that’s unlikely to be a diet with a long list of rules.

There is no fact here, no known knowledge about how to maintain weight loss. At best weight loss theory is highly theoretical with many factors, most of which science doesn’t really understand. At worst it is anecdote and hyperbole – the kind that Dr Oz rolls out repeatedly on his television show. (As an aside please watch this awesome destruction of Dr Oz by John Oliver, brilliance). 

Really Bezzant’s article should have the following conclusion, one that does not make a perverted logic leap. Read her original with my new conclusion, I think you will agree it is an improvement! 

“There are lots of ways to temporarily lose weight, and different things will work for different people, depending on lifestyle, lifestage, personality and willpower.


But the fact remains (and we have only figured this out in the last decade) that promoting weight loss is a fallacy, something that is done to sell books and exercise contraptions, and magazines, and that has obviously been happening since at least as early as 1966. Clearly the author of ‘The Complete Woman Book of Successful Slimming’ was not privy to what we know now; as such we can’t judge their product as an ethical failing, but simply as an artefact of the times” 

Of course, we can however judge current weight-loss books, contraptions, magazines and articles in the Sunday Star Times as ethical failings.

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Look at the illness, not the fantasy: Dom Post Op-Ed

Here is the text from a op-ed Bill Kaye-Blake from http://gropingtobethlehem.wordpress.com/ and I have today in the Dom Post. Just trying to move the debate away from the illogic and ideology of the contested term ‘obesity’.

Should sugary drinks be taxed? It’s certainly easy to see the case for doing so.

Studies suggest they increase the rate of diabetes, and that sugar-sweetened beverages are worse for diabetes than other drinks, calorie-for-calorie.

Diabetes is increasing in New Zealand and its treatment is demanding more resource from our public health budgets, so there is no doubt that reducing diabetes would save taxpayers money.

Further, it is clear that we can reduce the consumption of sugary drinks by taxation. Consumers react to higher prices by buying less – this works with New Zealand consumption data as well as when looking at the overseas implementation of similar taxes.

There is also good economic reasoning for such a tax.

Sugar-sweetened beverages create a cost for the public health system.

The person enjoying the drink and the companies profiting from it are creating costs that fall on everyone.

From this perspective taxing these drinks is just a case of “getting the prices right”, and then letting individuals make their own choices.

However, there is a deeper fantasy at work driving public health campaigns: a fantasy of perfect bodies and perfect taxes.

The economic logic for sugar- sweetened beverage taxes is unassailable by itself. Some people are creating costs for other people and should be made to pay compensation.

Of course, we are always creating costs and benefits for other people.

When we tidy our front gardens our neighbours get some enjoyment.

Perhaps we could remove a portion of the tax on the petrol used in lawnmowers because it leads to neatly manicured berms?

The fantasy is that we can perfectly account for our community debits and credits. It relies on the notion that we have some sort of personal account where our community contributions can be set against our drawings.

The fantasy is that we can fine-tune our accounting, so that no one is overdrawn and no one has to over- contribute.

In reality, this fantasy ends up being mediated in some way through legislation.

When we recognise a form of consumption that creates significant and calculable costs, we respond with taxation or some other legal route (such as prohibition).

Tobacco and petroleum products are examples of taxed products. The products formerly known as “legal highs” are examples of prohibited ones.

This process of mediation is what prevents “silly” taxation policy – such as a tax break on petrol for lawnmowers.

For sugar-sweetened beverages, the device of mediation (where fantasy becomes law) should be in the areas where they have been rigorously implicated – diabetes and dental health being the most obvious.

These conditions by themselves justify the sorts of taxes proposed.

But a major focus of the calls from many “health” campaigners is the impact that taxing these drinks might have on the contested term “obesity”.

The focus on obesity reveals the other public health fantasy: socially engineering perfect bodies.

There is no sense in attempting to tie a tax on sugar-sweetened beverages, or any food consumption, to obesity.

As a concept, obesity is extremely problematic for many reasons – body composition being the most commonly accepted one.

For example, Richie McCaw is obese by the standard of Body Mass Index (BMI).

If, for instance, we decided to tax sugar-sweetened beverages and had a subsequent reduction in diabetes and improvement in dental health, would the tax be judged unsuccessful if BMI didn’t change?

In fact, diabetes and poor dental health affect people of all body sizes, who can all be healthier, regardless of BMI. But if a sugary drink tax collected enough healthcare funding to pay for diabetes and dental care, would public health campaigners still demand more just to make people slimmer?

What we must ponder is why public health campaigners and researchers feel the need to complicate a very simple relationship by dropping in the term obesity whenever possible, despite its longstanding logical and ideological problems.

Or, put differently: why are they so determined to define and control body mass when they could just target disease?


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The Evil of the BMI Calculator

Today I was trawling the web for a BMI calculator to work out Richie McCaw’s Body Mass Index measure (Richie is the captain of the All Blacks, we love Richie). His BMI is around 30 it seems, just obese – well done Richie! Anyway I came upon this calculator provided by the Australian Heart Foundation. It is notable because it also provides a useful (oh wait, I mean useless) diagram of what you must look like. So I plugged my height and weight into the boxes and here is the lovely response:

Image So I thought I would post a photo of what my body actually looks like (sorry – couldn’t bring myself to do the nude shot):



and no… I don’t do weights, go to the gym or anything else silly like that. I just run as much as I can fit into my schedule. So my message to the Australian Heart Foundation is pretty simple – take down your stupid, abusive, misleading BMI calculator with the added ‘fat bastard’ image generator. It is offensive, plain and simple.




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Modernisation not good for health: Whaaaat?

I’m sure you have all seen the headlines in the last few days about how large we all are etc… The rhetoric is pretty boring and standard, not much analysis for me to add aside from the usual, being based on the BMI measure and all that.

But I was not expecting the level of ridiculous claims that have been reported in the herald: http://nzh.tw/11263914. I’ll quote one lovely section:

“Modernisation has not been good for health,” said Syed Shah, an obesity expert at United Arab Emirates University, who found obesity rates have jumped five times in the last 20 years even in a handful of remote Himalayan villages in Pakistan.

Come on Dr Shah, you are looking at a thin slice of a very large health pie. Similar to NZ the average life expectancy in Pakistan has increased about 7 years between 1980 and now and they have also got larger. In NZ for instance we live about 7 years longer than in 1980 and the middle point human (middle weight middle height) is about 7kg heavier.

The point is that Modernisation is great for health. You can’t say it isn’t,  they just want to see weight increase as inherently bad. I can’t wait for this tripe to be replaced with the far more interesting issues of commodification of culture, capital control, and security.  I imagine these are more interesting to the average Pakistani?

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Dave Shaw: A Positive Review and Some Advice

It isn’t often that I’m positive on this blog. Mostly because the wider weight industry is so absolutely completely ridiculous that positivity is ruled out as a rule, so to speak. However very occasionally I read something that has merit, which in this turgid industry deserves respect. So in this article I want to recognise this dude Dave Shaw. To be honest I don’t know Dave, never met the guy and have only just read a couple of his posts on the Herald site. I quite enjoyed his take on the Big Fat Debate aired by Third Degree here in NZ for instance.

The title of his latest offering is not intriguing. 10 steps to a diet you can do for life could win awards for its mundanity. It is the kind of title that drew me in, I thought “excellent, more fodder for a critical health scholar”. Sadly I was disappointed. Shaw’s writing has a certain kind of inclusive safety to it, a sort of democratic egalitarian purpose that is so often missing when people write about ‘health’. Now I am not saying that all this is great, certainly it has problems, some of which I note below. But overall I am impressed. In the article Shaw does his level best to recommend ’10 steps’ towards negotiating the opposing totalising stupidity that is the diet industry. The finale presents:

1. Acknowledge that no one diet is best and the overall pattern of our eating matters the most, not a single supplement, food or meal. 
2. Remember, the best way to control the quantity of calories our body needs without feeling hungry is to improve the quality of those calories. Choose real, wholesome foods. 
3. Recognise that some foods are unhealthier than others and eat less of these. 
4. Be lenient from time to time. All foods, including treats, can be a part of a healthy diet. But don’t allow unhealthier options to hold the power. Eat it, enjoy it and move on. 
5. Eat fat including saturated, mono-unsaturated and poly-unsaturated types. Just make sure it comes from food found in nature, not a factory. 
6. Eat heaps of plants, especially non-starchy vegetables. 
7. Eat meat if you want to, but not everyday. Instead, use other excellent sources of protein like poultry, fish, legumes and dairy. 
8. Cook whenever you can and allow yourself to eat whatever you cook, but only if you cook from scratch. 
9. Alcohol is not banned, but not encouraged. 
10. If your diet is like this 6 out of 7 days you’re doing well. 

Now those of you who know me will recognise that I could find much within the steps above to ridicule, both from the scientific literature and from critical health studies. But putting those things aside for a moment one has to see the inherent reason within Shaw’s take. Thankfully he doesn’t mention weight even once above… for this and this alone thank you Dave!

Ok, so now onto a couple of things I would like to address directly. I mention these not as direct criticism of the content of the article but from the perspective of this ex-biochemist turned critical social scientist. I shall present a set of just 4 items for reflection:

  1. The dangerous word ‘best’: Many times you use the term ‘best’, sometimes in contradictory ways. The problem with this word is it implies that a greater power exists that has this diet shit figured out, which is obviously not the case as you yourself lean on regularly (particularly in the Third Degree post). Just like the term ‘best practice’ in business should read ‘good practice’ your article improves if you replace many of the instances with the word ‘good’. The only time it should be left in is when you refer to its reified form, such as in step 1 above. Here it should read “The Best”, as in a fantasy that does not exist.   
  2. Human’s were not made. Yeah, in paragraph 4… “Human’s were made to”… human’s evolved to be omnivores independent of a maker of any kind. No one made us, this kind of slippage is symptomatic of our tendency to look for the ‘best’. An easy mistake to make, but precision is important here.
  3. Food access is a massive problem (much bigger than we think): It is important to recognise the many and varied factors that prevent access to the kind of food that you tend to promote (which is the kind of food I eat). I know that your previous articles have touched on this issue, such as this on the cost of healthy eating. But you need to consider many other access issues such as transport, history, culture, finances, and time to say just a few. It would be great to see you tackle some of these in future opinion pieces.
  4. Unified fronts can lead to fascism: Uniformity of thinking is a serious threat to the freedom, democracy and egalitarianism we enjoy in New Zealand. Do not wish for it in the diet industry or in public health, it would only create an even stronger ‘healthy’ class attempting to wield forces over those they deem ‘unhealthy’. Think encamping fat people, removing fat children from parents etc… it might seem ludicrous but unified fronts concentrate power.

In sum, I can honestly say that Dave Shaw appears to be one of the ‘best’ (yes, I’m being facetious) mainstream nutrition authors currently writing in the New Zealand media. I can only add that I hope he keeps it up and keeps learning – maybe even from us critical social scientists?  


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