Head, Public Health Advocacy and Policy Impact Centre, The George Institute for Global Health
Director, WHO CC Salt Reduction
Professor, Faculty of Medicine, UNSW Sydney
You are a passionate healthy eating advocate. What inspired you to work in health research?
I have always been interested in food. I grew up on a farm in North Yorkshire in England. Everything was home cooked or from the farm or garden. Mum thought that buying anything like jam or packet gravy from the shop was cheating.
I studied Sociology and then International Development which was when I first became aware of the massive inequalities in relation to food security globally. My first job was advocating for food policies to improve health for people on low incomes in the UK. Later I worked for the UK Food Standards Agency where I helped establish the UK government’s successful salt reduction strategy.
The George Institute’s researchers are leading thinkers on global health. What do you see as the most pressing goals for public health?
A lot of my research to date has been on reducing population salt intake by supporting companies to take salt out of foods and meals. But increasing the focus and spending of governments on prevention policies more broadly is urgently needed. This includes improving environments to support healthier living through better food and nutrition, improved mental health and reduced injuries.
What would you like to see come out of your work with the new think tank?
The George Institute’s research focuses on low cost solutions that have the potential to improve the health of millions of people globally. Our new think tank initiative is about ensuring our research influences policy and practice and ultimately affects people’s health. We will tackle this through cross-cutting issues including healthy living environments, improved health systems, women’s health inequalities and social enterprises. We will engage a suite of different channels including digital media and events to share insights, challenge the status quo and foster the kinds of debates that can deliver real impact in relation to health, both in Australia and globally.
What do you find most intriguing about healthy eating research?
Every individual is different and the factors that influence food choices are complex and changing. The move towards personalised nutrition is fascinating but probably only relevant to a small minority of self-motivated people – for the vast majority of people the food environment, including price, availability, culture, knowledge, and skills, is what influences their daily food choices. Telling people what to eat won’t have much of an impact unless we can change the food environment.
What kind of diets would you like us all to be eating in the near future?
There’s no one size fits all when it comes to diets but in general it would be good to see a shift towards increased consumption of fresh foods and less processed foods. The VicHealth Salt Reduction Partnership tagline, “If it’s packed, chances are it’s packed with salt,” says it all. We need to enable people to eat more fresh foods, including fruits and vegetables, and less processed foods. Obviously, not everyone is going to be able to cook from fresh at home every day so we need to be ensuring that manufacturers increase the healthiness of processed packaged foods and that restaurants and food outlets sell healthier meals.
How have you changed your lifestyle as you learn more about diet through your work?
There isn’t really much I won’t eat occasionally. I love food and enjoy eating out and entertaining. So I try to balance this out by bringing healthy lunches to work and making sure we only have healthy meals and snacks at home most of the time.
When do you think health initiatives work best? Can you give an example of how our research has made a big impact on people's lives, such as with regards to better dietary choices?
Certainly, one of the reasons for the success of the UK salt reduction strategy (that has already reduced salt by 15% and estimated to be saving around 9000 lives a year) was the fact that research, advocacy, government and industry were all brought together on the same page. Plus, the main focus was changing the food environment – in this case reducing salt levels in foods and meals – which was key to success.
Salt reduction programs also have great potential in developing countries and sometimes changes can be made quite quickly. As part of a visit to Mongolia, I visited a bread factory and discussed the importance of reducing salt with the manager who immediately reduced the amount of salt added to the bread in the factory – which was producing 50% of the bread in Mongolia. This would have had an immediate and significant impact on people’s health in Mongolia.
But not all changes are that easy. Processed foods are increasingly available in many countries, and I’m concerned about the rising consumption of products like instant noodles, which may be cheap and convenient, but contain huge amounts of salt.
What keeps you motivated to keep helping people eat better?
Initially my interest was in tackling malnutrition in the form of people not having enough to eat. But over the last 10-15 years, my priority has shifted to the growing problem of people eating too much, or the wrong kinds of foods, leading to non-communicable diseases such as diabetes or cardiovascular disease. It’s not difficult to stay motivated. Food systems are complex and there is always something new to learn. Plus, everyone loves to talk about food and health.
The George Institute researchers mainly focus on prevention and low-cost solutions, which ones are you most excited about?
One example is the new affordable dialysis machine that has the potential to massively increase access to this life-saving treatment for people with kidney disease globally.
Meanwhile, SMARThealth provides an exciting opportunity to improve efficiency of patient healthcare in many countries and our trials of a new combination pill (that combines treatments for multiple risk factors) will help to increase adherence and has the potential to dramatically cut costs to health budgets around the world.
These are just some of the examples of low-cost solutions that can deliver impact in relation to healthcare choices, treatment and improving efficiencies of healthcare systems. Our challenge now is to make sure the right people know about them so that they are integrated into policy and practice and ultimately impact people’s health and save lives.